Persistent Opioid Use in Body Contouring Patients
Katelyn G. Bennett, MD, Brian P. Kelley, MD, Vidhya Gunaseelan, MS, MHA, Jennifer F. Waljee, MD, MS.
University of Michigan, Ann Arbor, MI, USA.
Purpose: Recent studies indicate that roughly 6% of opioid-na´ve patients undergoing elective procedures develop new persistent opioid use. Body contouring is commonly performed to enhance quality of life and appearance, but opioid prescribing patterns among this population remain unknown.
Methods: We examined insurance claims from OptumInsight between 2001 and 2015 for opioid-na´ve patients undergoing five common body contouring procedures: abdominoplasty/panniculectomy, breast reduction, mastopexy, brachioplasty, and thighplasty (n=17,894). Our primary outcome included new persistent opioid use, defined as prescription fills between 90 and 180 days after the operation. We used multilevel mixed-effects logistic regression to assess the risk of new persistent use, adjusting for clinical and sociodemographic covariates.
Results: In this cohort, 12.8% of previously opioid-na´ve patients filled opioid prescriptions beyond 3 months after surgery. New persistent use was higher among older patients (ages 55-64, OR 1.53, CI 1.37-1.83) and those with greater comorbid conditions (Elixhauser score >3, OR 2.37, CI 2.08-2.71), as well as patients with depression (OR 1.28, CI 1.10-1.49), anxiety (OR 1.34, CI 1.20-1.51) neck pain (OR 1.21, CI 1.09-1.35), back pain (OR 1.48, CI 1.31-1.68), and other pain disorders (OR 1.92, CI 1.74-2.12). Income above $100K (OR 0.83, CI 0.70-0.97) and breast reductions (OR 0.42, CI 0.21-0.87) were protective against persistent use.
Conclusions: After body contouring surgery, more than 10% of opioid-na´ve patients developed persistent use. Plastic surgeons must encourage opioid alternatives and optimize transitions of care in vulnerable patients.
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