Physician opioid prescribing significantly increases risk of addiction

London researchers from ICES Western have shown that men who filled a prescription for opioids after minor surgery were at significantly higher risk of persistent long-term opioid use and hospitalization for opioid overdose, than those who did not.

The study, “An Opioid Prescription for Men Undergoing Minor Urologic Surgery Is Associated with an Increased Risk of New Persistent Opioid Use,” demonstrates the connection between physician prescribing and potential for opioid addiction.

“The main message here is that opioid prescriptions after minor procedures do present long-term harm and they are something that should be avoided if possible,” said lead author, Dr. Blayne Welk, associate professor at Western’s Schulich School of Medicine & Dentistry and Scientist at Lawson Health Research Institute.

Welk and his team examined de-identified health data through ICES Western for 90,000 men in Ontario, who underwent minor urologic surgeries, mainly vasectomies, between 2013 and 2016. 

Of those, 35 per cent were prescribed and filled a prescription for narcotics. This group of patients was significantly more likely than those who didn’t fill their prescription, to fill another two prescriptions for opioids within the next nine to fifteen months. The researchers used this metric as a signal of persistent long-term use.

The researchers also found that those who filled their prescription for narcotics were three times more likely to be hospitalized for opioid overdose and other opioid-related harms, though this incidence was rare overall.

Dr. Welk says one of the challenges is that there currently aren't consistent guidelines for how to manage pain after these types of surgeries. 

“Most of the time for these minor procedures, a patient can manage their pain without narcotics, and I think that's the real message here,” Dr. Welk said.

“After the surgeries we studied, only a third of patients filled an opioid prescription, so the other two-thirds managed without them.”

Urologists were more likely to prescribe opioids than general practitioners after these minor procedures, and Dr. Welk hopes this research prompts increased awareness from urologists about opioids prescribing.