Trends in opioid prescription for craniomaxillofacial trauma in the United States: An 11-year retrospective study of emergency room and office visits

Surgery. 2021 Jul;170(1):232-238. doi: 10.1016/j.surg.2021.03.007. Epub 2021 Apr 17.

Abstract

Background: Facial trauma is associated with significant long-term morbidity and pain. These patients are routinely prescribed opioid medication and are at risk for opioid dependence. Rates and trends in opioid prescription in the ambulatory setting for management of craniofacial trauma are unknown.

Methods: The National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey data were analyzed from 2006 to 2016. Using International Classification of Diseases codes, 7,997,454 visits for craniomaxillofacial trauma were identified. Trends in opioid and nonopioid prescriptions were studied, with variables of interest including demographics, geographic region, expected source of payment, and injury location.

Results: Over the study period, trends in both opioid and nonopioid prescriptions remained stable, with about 13.4% of all visits receiving opioid prescriptions. Patients aged 18 to 44 (P < .001) and lower face trauma (P = .047) were associated with increased rates, while Medicare and charity payers (P < .001) were associated with lower rates of opioid prescriptions. There was no significant difference in prescription rates across geographical regions, by ethnicity, or sex.

Conclusion: Opioid medication forms the cornerstone for ambulatory management of craniofacial trauma. Despite increased awareness and emphasis on multimodal pain management, opioid prescription trends have remained relatively stable over time.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Analgesics, Opioid / therapeutic use*
  • Craniocerebral Trauma / drug therapy
  • Drug Prescriptions / statistics & numerical data*
  • Emergency Service, Hospital
  • Facial Injuries / drug therapy*
  • Female
  • Health Care Surveys
  • Humans
  • Male
  • Middle Aged
  • Office Visits
  • Pain Management
  • Retrospective Studies
  • Sex Distribution
  • United States
  • Young Adult

Substances

  • Analgesics, Opioid