Study eyes minor surgery opioid prescriptions

Men who filled a prescription for opioids after minor surgery were at significantly higher risk of persistent long-term opioid use and hospitalization for opioid overdose than those who did not, according to a Western-led study. The findings serve as a clear warning for physician prescribing such powerful, addictive drugs after these type of procedures.

The study, An Opioid Prescription for Men Undergoing Minor Urologic Surgery Is Associated with an Increased Risk of New Persistent Opioid Use, was recently published in the journal European Urology.

“The main message here is that opioid prescriptions after minor procedures do present long-term harm and they are something that should be avoided if possible,” said Dr. Blayne Welk, a Schulich School of Medicine & Dentistry professor and Lawson Health Research Institute scientist.

Welk and his team examined de-identified health data through the Institute for Clinical Evaluative Sciences (ICES Western) for 90,000 men in Ontario who underwent minor urologic surgeries, mainly vasectomies, between 2013-16.

Of those, 35 per cent were prescribed and filled a prescription for narcotics. This group was significantly more likely to fill another two prescriptions for opioids within the next nine-15 months. The researchers used this metric as a signal of persistent long-term use.

The researchers also found that those who filled their prescription for narcotics were three times more likely to be hospitalized for opioid overdose and other opioid-related harms, though this incidence was rare overall.

Welk, who served as lead author of the study, says one of the challenges is that there currently aren’t consistent guidelines for how to manage pain after these types of surgeries.

“Most of the time for these minor procedures, a patient can manage their pain without narcotics, and I think that’s the real message here,” Welk said. “After the surgeries we studied, only a third of patients filled an opioid prescription, so the other two-thirds managed without them.”

Urologists were more likely to prescribe opioids than general practitioners after these minor procedures, and Welk hopes this research prompts increased awareness from urologists about opioids prescribing.