Persistent opioid use is common after acute musculoskeletal injuries

  • Riva JJ & al.
  • Ann Intern Med
  • 18.08.2020

  • von Kelli Whitlock Burton
  • Clinical Essentials
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Takeaway

  • Almost 11% of adult patients who receive an opioid prescription for acute musculoskeletal injuries developed persistent opioid use.
  • Chronic use is more than 4 times higher among high-risk patients than those at low risk.

Why this matters

  • Avoiding opioid prescriptions after musculoskeletal injuries in patients with a history of substance use disorder, especially among older patients, could reduce the risk for persistent opioid use.

Study design

  • Meta-analysis of 13 studies with 13,263,393 adult patients who received opioid prescriptions for acute musculoskeletal injuries.
  • Funding: National Safety Council.

Key results

  • Overall prevalence of persistent opioid use was 10.6%.
  • 26.9% of high-risk patients experienced prolonged opioid use vs 5.9% of those at low risk (P<.001>
  • For every 10-year increase in risk for persistent opioid use, factors associated with absolute risk increase (95% CIs) included:
    • Older age: 1.1% (0.7%-1.5%).
    • Physical comorbidity: 0.9% (0.1%-1.7%).
    • Past or current substance use disorder: 10.5% (4.2%-19.8%).

Limitations

  • Risk for bias was a factor in most included studies.