Amid continuing concerns about the opioid abuse epidemic in the United States, new research suggests that individuals prescribed the powerful painkillers during and after plastic surgery may face a particularly high risk of developing addictions, raising questions about whether the widespread use of the opioids is appropriate and justified.
In a study published this month in the medical journal JAMA Facial Plastic Surgery, researchers from Stanford Hospital and Washington University School of Medicine found that patients who underwent breast augmentation or tummy tuck procedures had the highest risk of plastic surgery opioid addiction, which may be due to the invasive and painful nature of these procedures.
Stanford researchers analyzed data from nearly 500,000 patients who underwent one of five plastic and reconstructive surgeries between January 1, 2007, and December 31, 2015. The surgeries included eye, nasal, breast, abdomen, and soft tissue reconstruction.
More than 200,000 of those patients filled prescriptions for opioid painkillers after their surgery, and were given opioids during the surgical procedures.
Persistent opioid use occurred in seven percent of patients, according to the findings. That is the equivalent of nearly 31,000 patients using narcotic painkillers, like Vicodin or Oxycodone, for 90 to 180 days postoperatively.
Furthermore, more than two percent of patients, or roughly 11,000, had prolonged use of opioid painkillers. These patients used painkillers for 181 to 365 days after surgery.
In recent years, the opioid crisis in the United States has generated widespread concern about overuse of the painkillers, and questions about when it is appropriate to prescribe the addictive drugs. It is now more likely for an American to die from accidental opioid overdose than dying in an auto accident, and data indicates that opioids account for nearly 70% of all drug overdose deaths, leading to 64,000 overdose deaths in 2016 alone.
In the new study, breast and tummy tuck procedures had the highest risk of opioid addiction. These patients were more likely to become addicted after using the painkillers after surgery.
Patients who also faced increased risk of addiction were those who were given opioid painkillers during their procedures.
Additionally, patients with anxiety, depression, substance abuse, and chronic pain diagnoses had higher rates of addiction postoperatively.
Roughly 18 million Americans underwent cosmetic procedures in 2017. That rate increased from 5.5 million in 2000 and is expected to continue to increase each year.
With more patients opting for plastic surgery, researchers emphasize a need for better screening by surgeons, who should focus on history of addiction and depression when deciding whether to prescribe the drugs.
The opioid epidemic has largely been blamed on doctor prescribing habits, which have been driven by aggressive marketing by the drug makers. Recent research suggested that opioids are prescribed 30% of the time without documenting an actual pain diagnosis. They were often given for visits with diagnoses of hypertension and high cholesterol, leading to more addiction.
Another study published in 2016 indicated inappropriate painkiller prescribing decreased when doctors were monitored. The monitoring program reduced prescriptions by 30%.
Furthermore, researchers call on surgeons to opt for non-opioid pain medications for elective plastic surgery, especially considering the surgery is not something that is needed to save a person’s life.