Household Exposure to Substance Abuse and the Risk of New Persistent Opioid Use After Cancer Surgery

Background: Household-level factors may also influence the risk of new persistent opioid use (NPOU). We sought to assess the risk of NPOU among individuals with household exposure to substance abuse.

Methods: Opioid-naïve individuals who underwent oncological procedures were identified using the IBM MarketScan database. Multivariable regression equations were used to assess the association between household exposure to substance abuse and NPOU.

Results: Among 10 557 individuals 4.9% (n = 520) had a family history of substance abuse. Patients with a family history of substance abuse were more likely to use opioids during the perioperative (85.0% vs. 78.8%) and postoperative periods (40.2% vs. 34.1%) (both p < 0.05). Moreover, perioperative (300 MME [IQR: 450-200] vs. 250 MME [IQR: 150-435]) and postoperative (525 MME [IQR: 1348-225] vs. 350 MME [IQR: 150-850]) opioid dose was also higher among patients with a family history of substance abuse (both p < 0.001). On multivariate analysis, patients with family history of substance abuse had 37% (OR 1.37, 95% CI 1.07-1.75) higher odds of NPOU.

Conclusion: Among opioid-naïve individuals undergoing oncological procedures, a family history of substance abuse is associated with NPOU. Patients should be screened for household-level factors before prescribing opioids for perioperative use.