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Original research
Incidence of persistent opioid use following traumatic injury
  1. Matthew C Mauck1,2,
  2. Ying Zhao2,
  3. Amy M Goetzinger2,
  4. Andrew S Tungate1,2,
  5. Alex B Spencer2,
  6. Asim Lal1,2,
  7. Chloe E Barton1,2,
  8. Francesca Beaudoin3 and
  9. Samuel A McLean1,4
  1. 1Institute for Trauma Recovery, The University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
  2. 2Anesthesiology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
  3. 3Department of Emergency Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  4. 4Emergency Medicine, The University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
  1. Correspondence to Dr Matthew C Mauck, Institute for Trauma Recovery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill CB#7011, North Carolina, USA; Matt_Mauck{at}med.unc.edu

Abstract

Introduction Major traumatic injuries are a known risk factor for persistent opioid use, but data describing the relationship between specific traumatic injuries and opioid use is lacking.

Methods We used insurance claims data from January 1, 2001 to December 31, 2020 to estimate the incidence of new persistent opioid use in three hospitalized trauma populations: individuals hospitalized after burn injury (3809, 1504 of whom required tissue grafting), individuals hospitalized after motor vehicle collision (MVC; 9041), and individuals hospitalized after orthopedic injury (47, 637). New persistent opioid use was defined as receipt of ≥1 opioid prescriptions 90–180 days following injury in an individual with no opioid prescriptions during the year prior to injury.

Results New persistent opioid use was observed in 12% (267/2305) of individuals hospitalized after burn injury with no grafting, and 12% (176/1504) of burn injury patients requiring tissue grafting. In addition, new persistent opioid use was observed in 16% (1454/9041) of individuals hospitalized after MVC, and 20% (9455/47, 637) of individuals hospitalized after orthopedic trauma. In comparison, rates of persistent opioid use in all trauma cohorts (19%, 11, 352/60, 487) were greater than the rates of persistent opioid use in both non-traumatic major surgery (13%) and non-traumatic minor surgery (9%).

Conclusions These data demonstrate that new persistent opioid use frequently occurs in these common hospitalized trauma populations. Improved interventions to reduce persistent pain and opioid use in patients hospitalized after these and other traumas are needed.

  • CHRONIC PAIN
  • Analgesics, Opioid
  • Outcome Assessment, Health Care
  • Pain Management

Data availability statement

Data may be obtained from a third party and are not publicly available. IBM MarketScan.

https://doi.org/10.1136/rapm-2022-103662

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. IBM MarketScan.

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    Footnotes

    • Contributors MCM contribution to the manuscript was conception of idea, writing, analysis, critical revision, and decision to publish. MCM serves as the guarantor for the work presented in the manuscript. AST and YZ contribution was data management and interpretation, and statistical analysis. AL contributed with literature search, writing, and critical analysis. ABS contributed to writing and critical revision of the manuscript. CEB contribution was literature search, writing, and analysis. FB contributed to writing. AMG contributed to writing and critical revisions. SAM contribution to the manuscript was conception of idea, writing, and critical revision.

    • Funding Research reported in this publication was supported by the University of North Carolina Department of Anesthesiology. Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute Of Child Health & Human Development of the National Institutes of Health under Award Number K12HD001441. The database infrastructure used for this project was funded by the Department of Epidemiology, UNC Gillings School of Global Public Health; the Cecil G. Sheps Center for Health Services Research, UNC; National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR002489.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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