Association Between Surgical Opioid Prescriptions and Opioid Initiation by Opioid-Naïve Spouses

Ann Surg. 2021 Dec 23. doi: 10.1097/SLA.0000000000005350. Online ahead of print.


Objective: To determine whether surgical opioid prescriptions are associated with increased risk of opioid initiation by operative patients' spouses.

Summary background data: Adverse effects of surgical opioids on operative patients have been well described. Whether risks of surgical opioids extend to operative patients' family members is unknown.

Methods: This was a retrospective cohort study of opioid-naïve, married patients undergoing 1 of 11 common surgeries from 1/1/2011-6/30/2017. The adjusted association between surgical opioid prescriptions and opioid initiation by the operative patient's spouse in the 6-months following surgery was assessed. Secondary analyses assessed how this association varied with postoperative time.

Results: There were 318,022 patients (mean ± SD age 48.8 ± 9.3 years; 49.5% women). Among the 50,833(16.0%) patients that did not fill a surgical opioid prescription, 2,152(4.2%) had spouses who filled an opioid prescription within 6-months of their surgery. In comparison, among the 267,189(84.0%) patients who filled a surgical opioid prescription, 15,026(5.6%) had spouses who filled opioid prescriptions within 6-months of their surgery (unadjusted P < .001; adjusted odds ratio[aOR] 1.37, 95%CI 1.31-1.43, P < .001). Associated risks were only mildly elevated in postoperative month 1 (aOR 1.11, 95%CI 1.00-1.23, P = 0.04) before increasing to a peak in postoperative month 3 (aOR 1.57, 95%CI 1.39-1.76, P < .001).

Conclusions: Surgical opioid prescriptions were associated with increased risk of opioid initiation by spouses of operative patients, suggesting that risks associated with surgical opioids may extend beyond the surgical patient. These findings may highlight the importance of preoperative counseling on safe opioid use, storage, and disposal for both patients and their partners.