Surgery may trigger opioid abuse in teens and young adults

Could post-surgery painkillers be the path to addiction?
Could post-surgery painkillers be the path to addiction?

Opioids are a class of drug that include illegal substances like heroin, as well as prescription pain relievers like oxycodone, hydrocodone, codeine and morphine.

The reason why opioids can be highly addictive is because they cause the brain to release dopamine, a neurotransmitter that brings about feelings of pleasure. With repeated exposure, these drugs can however become habit-forming.

Teens and young adults who have surgery may be at increased risk for opioid painkiller abuse, a new study indicates.

Substances believed not to be addictive

Opioids such as oxycodone (OxyContin) and hydrocodone (Vicodin) are commonly prescribed for pain after surgery.

"And until recently, it was generally believed they were not addictive," said study lead author Dr Calista Harbaugh. She's a general surgery resident at the University of Michigan Medical School.

"The study is an important step toward recognising that the [US] opioid epidemic is affecting adolescents and young adults in a major way," Harbaugh said in an American Academy of Pediatrics news release.

Persistent opioid use

For the study, researchers analysed data from nearly 90 000 privately insured US patients aged 13 to 21 (average age 17) who underwent one of 13 common surgeries in this age group. The patients had no history of opioid painkiller prescriptions before their surgery.

The investigators looked for persistent opioid use – defined as continued prescription refills 90 to 180 days after the surgical procedure and beyond what is expected after routine surgery.

The overall rate of persistent post-surgical use was nearly 5%, ranging from less than 3% to more than 15% depending on the type of surgery and other factors, the findings showed.

The rate was 0.1% in a "control group" of teens and young adults who did not have surgery.

Leftover prescriptions

Patients who underwent gallbladder removal and colon surgery had the highest risk of persistent opioid use. Older youth with other chronic conditions, depression, anxiety or prior substance use disorders also had an elevated risk, according to the study.

Recent research has found that many adults become addicted to opioid painkillers after surgery, but this is the first study to suggest this problem also occurs in teens and young adults post-surgery, the researchers said.

"Most adolescents who misuse prescription opioids get the pills from leftover prescriptions of their family, friends, or their own," Harbaugh explained. "We need to make sure that we treat pain after surgery, but it must be balanced with the risk of providing more opioid than necessary to patients and their communities.

Alternative treatments

Health24 recently mentioned a study where alternative pain treatments were explored. These include:

  • Acupuncture
  • Electrotherapy (the use of electric energy to stimulate nerves and muscles)
  • Cryotherapy (the application of extreme cold to the region of surgery)
  • Machine-based rehabilitation (continuous passive motion)
  • Pre-surgery exercise regimens

Image credit: iStock

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