New research led by York University shows the strongest predictive factors for prolonged opioid use after a traumatic musculoskeletal injury and surgery are pain severity and a poor sense of control over pain. The study is published in The Journal of Pain, the peer-reviewed publication of the American Pain Society.
Scientists from York University, the University of Toronto and other Canadian centres hypothesized that pain severity measured in the hospital within two weeks of a musculoskeletal injury could predict use of prescription opioids four months after discharge. They also explored whether psychological distress would predict opioid use as much or more than pain severity.
The study is titled “Predictors of Prescription Opioid Use 4 Months After Traumatic Musculoskeletal Injury and Corrective Surgery: A Prospective Study.”
“Previous research has shown that people who sustain traumatic injuries are at higher risk than the general population for using and abusing opioids. Several studies have identified risk factors for persistent opioid use, such as a history of drug or alcohol abuse and taking medications for depression and anxiety,” said lead author Brittany Rosenbloom, a clinical psychology doctoral student at York University supervised by Professor Joel Katz. “However, the extent that acute post-surgical pain and chronic pain influence persistent opioid use is not clear.”
Results of the study, which employed secondary data analysis, showed that 35 per cent of 122 patients reported using a prescription opioid for pain relief four months following a traumatic musculoskeletal injury requiring surgery. These patients had significantly greater pain severity and pain interference scores than patients who were not using opioids.
“[The results support] the hypothesis that initial in-hospital pain severity would predict use of prescription opioids four months after surgery,” said Rosenbloom. “The data strongly suggest that pain severity and poor sense of pain control, not psychological distress, are the main factors associated with prolonged opioid use following musculoskeletal trauma and surgery. Further, when evaluating opioid use after injury, it is important to consider time since injury because factors associated with opioid use change over time.”