{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T04:13:42Z","timestamp":1770264822305,"version":"3.49.0"},"reference-count":34,"publisher":"BMJ","funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["5R01DA042859-04"],"award-info":[{"award-number":["5R01DA042859-04"]}],"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":["5R01DA058640-02"],"award-info":[{"award-number":["5R01DA058640-02"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009931","name":"Michigan Department of Health and Human Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009931","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,1,19]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Substance use among surgical patients is common and correlated with greater postoperative opioid use. However, the association of preoperative substance use on postoperative pain is unknown. In this context, a brief, validated tool such as the Tobacco, Alcohol, Prescription medication, and other Substance use (TAPS) Questionnaire could provide valuable information to assess the risk of poor postoperative pain control.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively identified adults aged 18 years and older undergoing common surgical procedures between December 2018 and July 2023 across three institutions. Patients completed the TAPS measure prior to surgery. A positive TAPS screen was defined as tobacco use \u2265monthly, heavy alcohol use \u2265monthly, any use of recreational drugs, or any use of prescription medication not as prescribed. The primary outcome was \u2018worst\u2019 overall pain (on a scale of 0\u201310, 0=no\u2009pain, 10=worst\u2009pain imaginable) at three time points: prior to surgery, 2\u2009weeks postoperatively, and 1\u2009month postoperatively. Mixed linear models were used to determine the association between TAPS Score and pain over time, adjusting for patient factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In this cohort of 4410 individuals, 42.2% reported unhealthy substance use using TAPS in the 12 months prior to surgery. After adjusting for patient factors, participants who screened positively on TAPS reported higher worst overall pain scores than those with negative TAPS screens at baseline (3.51 vs 3.15, p&lt;0.001) and at 1\u2009month postoperatively (2.66 vs 2.41, p=0.036). No significant difference was observed at 2 weeks after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative substance use is common and is correlated with higher levels of patient-reported pain after surgery, but within minimal clinically important differences. These findings are preliminary and require confirmation. Risky substance use has an important impact on postoperative recovery, and the perioperative window provides an opportunity to assess and intervene in unhealthy substance use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2025-107259","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:05:16Z","timestamp":1770217516000},"page":"rapm-2025-107259","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of patient-reported substance use and postoperative pain"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7032-3145","authenticated-orcid":false,"given":"Micaela Quinn","family":"Dugan","sequence":"first","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"University of Michigan Medical School, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic","family":"Alessio","sequence":"additional","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"Section of Plastic Surgery, Michigan Medicine, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenxun","family":"Xie","sequence":"additional","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"Institute for Healthcare Policy and Innovation, Michigan Medicine, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yenling","family":"Lai","sequence":"additional","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"Institute for Healthcare Policy and Innovation, Michigan Medicine, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chad M","family":"Brummett","sequence":"additional","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"Anesthesiology, Michigan Medicine, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9406-5953","authenticated-orcid":false,"given":"Mark C","family":"Bicket","sequence":"additional","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"Anesthesiology, Michigan Medicine, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer F","family":"Waljee","sequence":"additional","affiliation":[{"name":"Overdose Prevention Engagement Network (OPEN), Ann Arbor, Michigan, USA"},{"name":"Section of Plastic Surgery, Michigan Medicine, Ann Arbor, Michigan, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"2026020407050939000_rapm-2025-107259v1.1","unstructured":"Results from the 2021, 2022, and 2023 national surveys on drug use and health (samhsa publication no.pep24-07-020). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration; 2024. Available: https:\/\/www.samhsa.gov\/data\/report\/2021-2022-2023-nsduh-infographic"},{"key":"2026020407050939000_rapm-2025-107259v1.2","doi-asserted-by":"crossref","first-page":"e740","DOI":"10.1097\/SLA.0000000000005767","article-title":"Prevalence of Unhealthy Substance Use and Associated Characteristics Among Patients Presenting for Surgery","volume":"278","author":"Fernandez","year":"2023","journal-title":"Ann Surg"},{"key":"2026020407050939000_rapm-2025-107259v1.3","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jss.2020.03.015","article-title":"Opioid Misuse and Dependence Screening Practices Prior to Surgery","volume":"252","author":"Thiesset","year":"2020","journal-title":"J Surg Res"},{"key":"2026020407050939000_rapm-2025-107259v1.4","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1097\/SLA.0000000000006358","article-title":"Worth the Risk? Standardized Screening to Identify Substance Use Among Patients Before Surgery","volume":"282","author":"Cooley","year":"2025","journal-title":"Ann Surg"},{"key":"2026020407050939000_rapm-2025-107259v1.5","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1097\/SLA.0b013e3182988d59","article-title":"Preoperative alcohol consumption and postoperative complications: a systematic review and meta-analysis","volume":"258","author":"Eliasen","year":"2013","journal-title":"Ann Surg"},{"key":"2026020407050939000_rapm-2025-107259v1.6","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-010-1475-x"},{"key":"2026020407050939000_rapm-2025-107259v1.7","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182911913"},{"key":"2026020407050939000_rapm-2025-107259v1.8","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1097\/SLA.0000000000002117","article-title":"Effect of Preoperative Opioid Exposure on Healthcare Utilization and Expenditures Following Elective Abdominal Surgery","volume":"265","author":"Waljee","year":"2017","journal-title":"Ann Surg"},{"key":"2026020407050939000_rapm-2025-107259v1.9","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2023-104944"},{"key":"2026020407050939000_rapm-2025-107259v1.10","doi-asserted-by":"crossref","first-page":"e1225","DOI":"10.1097\/SLA.0000000000005392","article-title":"Postoperative Opioid Prescribing and New Persistent Opioid Use: The Risk of Excessive Prescribing","volume":"277","author":"Howard","year":"2023","journal-title":"Ann Surg"},{"key":"2026020407050939000_rapm-2025-107259v1.11","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1097\/SLA.0000000000003509","article-title":"Patient Factors Associated With Opioid Consumption in the Month Following Major Surgery","volume":"273","author":"Larach","year":"2021","journal-title":"Ann Surg"},{"key":"2026020407050939000_rapm-2025-107259v1.12","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S144066"},{"key":"2026020407050939000_rapm-2025-107259v1.13","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000081722.09164.D5"},{"key":"2026020407050939000_rapm-2025-107259v1.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68700-X"},{"key":"2026020407050939000_rapm-2025-107259v1.15","unstructured":"Instrument: taps tool. 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