{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:29:40Z","timestamp":1790393380376,"version":"4.1.0"},"reference-count":45,"publisher":"BMJ","issue":"8","funder":[{"DOI":"10.13039\/100009931","name":"Michigan Department of Health and Human Services","doi-asserted-by":"publisher","award":["E20221872-00"],"award-info":[{"award-number":["E20221872-00"]}],"id":[{"id":"10.13039\/100009931","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG024968"],"award-info":[{"award-number":["P30AG024968"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["T32GM108554"],"award-info":[{"award-number":["T32GM108554"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["K23DA057387"],"award-info":[{"award-number":["K23DA057387"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA050334"],"award-info":[{"award-number":["R01DA050334"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R01DA057284"],"award-info":[{"award-number":["R01DA057284"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2023,10,22]]},"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:sec>\n                  <jats:title>Background\/importance<\/jats:title>\n                  <jats:p>Considerable attention has been paid to identifying and mitigating perioperative opioid-related harms. However, rates of postsurgical opioid use disorder (OUD) and overdose, along with associated risk factors, have not been clearly defined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Evaluate the evidence connecting perioperative opioid prescribing with postoperative OUD and overdose, compare these data with evidence from the addiction literature, discuss the clinical impact of these conditions, and make recommendations for further study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Evidence review<\/jats:title>\n                  <jats:p>State-of-the-art narrative review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Nearly all evidence is from large retrospective studies of insurance claims and Veterans Health Administration (VHA) data. Incidence rates of new OUD within the first year after surgery ranged from 0.1% to 0.8%, while rates of overdose events ranged from 0.01% to 0.8%. Higher rates were seen among VHA patients, which may reflect differences in data completeness and\/or risk factors. Identified risk factors included those related to substance use (preoperative opioid use; non-opioid substance use disorders; preoperative sedative, anxiolytic, antidepressant, and gabapentinoid use; and postoperative new persistent opioid use (NPOU)); demographic attributes (chiefly male sex, younger age, white race, and Medicaid or no insurance coverage); psychiatric comorbidities such as depression, bipolar disorder, and PTSD; and certain medical and surgical factors. Several challenges related to the use of administrative claims data were identified; there is a need for more granular retrospective studies and, ideally, prospective cohorts to assess postoperative OUD and overdose incidence with greater accuracy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Retrospective data suggest an incidence of new postoperative OUD and overdose of up to 0.8% during the first year after surgery, but prospective studies are lacking.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2023-104944","type":"journal-article","created":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T11:25:15Z","timestamp":1699269915000},"page":"602-608","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Perioperative opioid prescribing and iatrogenic opioid use disorder and overdose: a state-of-the-art narrative review"],"prefix":"10.1136","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8368-701X","authenticated-orcid":false,"given":"Daniel B","family":"Larach","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9878-5704","authenticated-orcid":false,"given":"Jennifer F","family":"Waljee","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9406-5953","authenticated-orcid":false,"given":"Mark C","family":"Bicket","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0974-7242","authenticated-orcid":false,"given":"Chad M","family":"Brummett","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2264-4758","authenticated-orcid":false,"given":"Stephen","family":"Bruehl","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,11,6]]},"reference":[{"key":"2025101110172640000_49.8.602.1","unstructured":"Module 5: Assessing and addressing opioid use disorder (oud), Available: https:\/\/www.cdc.gov\/drugoverdose\/training\/oud\/accessible\/index.html#:~:text=OUD%20is%20defined%20in%20the,to%20as%20%22opioid%20addiction.%22 [Accessed 1 May 2023]."},{"key":"2025101110172640000_49.8.602.2","unstructured":"Highlights for the 2020 national survey on drug use and health, Available: https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/2021-10\/2020_NSDUH_Highlights.pdf [Accessed 1 May 2023]."},{"key":"2025101110172640000_49.8.602.3","first-page":"E623","article-title":"Association between socio-demographic and health functioning variables among patients with opioid use disorder introduced by prescription: a prospective cohort study","volume":"21","author":"Sanger","year":"2018","journal-title":"Pain Physician"},{"key":"2025101110172640000_49.8.602.4","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMra1508490","article-title":"Nonmedical prescription-opioid use and heroin use","volume":"374","author":"Compton","year":"2016","journal-title":"N Engl J Med"},{"key":"2025101110172640000_49.8.602.5","unstructured":"Ahmad F , Cisewski J , Rossen L , et al . 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