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Psychiatric Comorbidities Associated with Persistent Postoperative Opioid Use

  • Acute Pain Medicine (R Urman, Section Editor)
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Abstract

Purpose of Review

This review outlines the psychiatric comorbidities associated with persistent opioid use in the postoperative period. We finish our analysis with evidence-based, patient-centered interventions that can be rendered in the perioperative setting to decrease postoperative opioid requirements.

Recent Findings

Opioids are overprescribed in the USA, especially in the postoperative setting. Excess opioids can result in diversion and contribute to the ongoing opioid epidemic. Mental health and substance use disorders can contribute to persistent postoperative opioid use. Adequately managing these disorders preoperatively promises to reduce persistent postoperative opioid use. Due to the lack of homogenous, evidence-based recommendations on the appropriate quantity and duration of postoperative opioid therapy, there is wide variability in provider prescribing habits. Further research is needed to establish surgery-specific postoperative opioid therapy protocols.

Summary

Opioids continue to be a mainstay in the treatment of postoperative pain. Unmonitored postoperative opioid use can lead to opioid use disorder. Mental health disorders increase susceptibility to persistent postoperative opioid use. By managing these psychiatric illnesses preoperatively, clinicians have the ability to decrease opioid consumption postoperatively. Lastly, given the healthcare burden of opioid misuse and abuse, it is important to establish concrete protocols to guide provider-prescribing habits.

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  1. Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, 02115, USA

    Janet O. Adeola & Richard D. Urman

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Janet Adeola and Richard Urman helped write the article. The authors have seen, reviewed, and approved the final manuscript.

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Richard D. Urman reports unrelated funding and/or fees from Merck, Medtronic, AcelRx, and Pfizer. He is a Section Editor for this journal, but was not involved in the review of this manuscript.

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Adeola, J.O., Urman, R.D. Psychiatric Comorbidities Associated with Persistent Postoperative Opioid Use. Curr Pain Headache Rep 26, 701–708 (2022). https://doi.org/10.1007/s11916-022-01073-3

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