Opioid Use After Radical Prostatectomy: Nationwide, Population-Based Study in Sweden.

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Abstract:

North American studies have reported that ?3-7% of opioid-naïve surgical patients transition to chronic opioid use after a single prescription. We examined the risk of chronic opioid use following radical prostatectomy (RP) using nationwide Swedish data.For 25,703 men in National Prostate Cancer Register of Sweden who underwent RP, linkage was performed to the Prescribed Drug Register. Opioid use was assessed in three time periods: baseline (13-1 month preoperatively), perioperative (1 month before and after), and postoperative (1-12 months). Multivariable logistic regression was used to identify predictors of new late use (?1 opioid prescription in three consecutive months >2 months after surgery).Overall, 16,368 (64%) men filled an opioid prescription during the 13 months before or after surgery. Use of strong opioids increased over time and use of weak opioids decreased. 1.9% of men had opioid prescriptions during the baseline period, followed by a spike around surgery (59%), which sharply decreased in the second postoperative month. However, thereafter the proportion of men with opioid prescriptions remained slightly higher (2.2%) compared to the pre-RP baseline. Among chronic late users, 57% were previous users and 43% were new chronic users. Higher cancer risk category, greater comorbidity, unmarried status, and low educational level were associated with risk of new chronic opioid use.Slightly more than half of Swedish filled an opioid prescription after RP, and <1% became chronic opioid users. These rates are lower than previous studies of postoperative opioid use from North America. Click here to read full article on original source website