WEDNESDAY, May 15, 2019 (Pharmacist's Briefing) -- Opioid- naive patients treated for a surgical musculoskeletal injury, the quantity of opioid prescribed, but not opioid type, is associated with prolonged opioid use, according to a study published in the May 1 issue of the Journal of the American Academy of Orthopaedic Surgeons.
Matthew Basilico, from Harvard University and Harvard Medical School in Boston, and colleagues studied 17,961 opioid-naive adults treated for a surgical musculoskeletal injury to examine whether the initial opiate type was associated with prolonged opioid use.
The researchers found that patients discharged on hydromorphone or morphine versus hydrocodone had a higher likelihood of prolonged use in initial analysis. After adjustment for discharge morphine milligram equivalents (MMEs), opioid quantity was the only factor predictive of prolonged use. Discharge MME was associated with opioid type.
"Our analysis suggests that the notion that some opioid types are intrinsically more dangerous than others is a myth," the authors write. "Our results also highlight the importance of calculating equivalent opioid dosing when switching opioid types to avoid inadvertently prescribing patients significantly higher MME."