Home E-Weekly June 7, 2016

Patients Still Using Opioids Months After Total Joint Replacement

Published: June 6, 2016

Many patients undergoing total hip or knee replacement are still taking prescription opioid medications up to 6 months after surgery, even if their pain has improved, according to a study in the journal Pain.

A team of researchers from the University of Michigan studied the patterns of opioid use in 574 patients undergoing joint replacement, including those who were taking narcotics before surgery. Patients were then followed up at 1, 3 and 6 months post-op to assess rates of and risk factors for long-term opioid use.

About 30% of patients were taking opioids prior to their joint replacement. Of this group, 53% of knee replacement patients and 35% of hip replacement patients were still taking opioids 6 months after surgery. In those who were not using the drugs before surgery, only 8% of knee replacement patients and 4% of hip replacement patients continued taking opioids at 6 months post-op. Additionally, the researchers found that an improvement in knee or hip pain after arthroplasty did not reduce the likelihood of long-term opioid use in either group.

The researchers note that they did not identify one key reason that patients continued taking the drugs. However, they did say that the results show that physicians must be careful in prescribing opioids to total joint patients, especially if they are on the medications prior to surgery.

"We hypothesize that the reasons patients continue to use opioids may be due to pain in other areas, self-medicating affective distress and therapeutic opioid dependence," the researchers write. "A long-term goal includes the development of interventions to aid physicians and patients with opioid cessation following surgical interventions."

Kendal Gapinski

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