Patients With Burn Injuries at High Risk for Opioid Dependency

October 25, 2018

By Michael Bassett

BOSTON -- October 24, 2018 -- Patients with thermal injuries are at a higher risk than other previously studied surgical populations of developing long-term opioid dependency, according to results of a large database study presented here at the 2018 Annual Meeting of the American College of Surgeons (ACS).

Additionally, “risk for development of COU/OUR (chronic opioid use or opioid use disorder) demonstrated a dose-dependent relationship, increasing with higher percentage of total body surface area burned,” noted Heather Carmichael, MD, University of Colorado, Denver, Colorado, on October 23.

Dr. Carmichael and colleagues used their institution’s network database of ~1.9 million patients to identify those who had suffered burns between 2012 and 2017 and identified those who had previously been diagnosed with COU or OUD. Other patients were considered to be opioid naive and were followed for 12 months to determine whether they developed COU/OUD.

Of 3,720 patients identified with burn injuries (59.7% male; 64.0% white), 170 patients (4.6%) had preexisting COU/OUD, whereas 150 patients (4.2%) developed COU/OUD in the 12 months after the injury.

Of the 150 opioid-naive patients who developed COU/OUD subsequent to burn injuries, 3.6% had burns over

The researchers suggested that future research should consider risk factors, social and physiologic mechanisms for the development of COU/OUD in burn patients, and the use of nonnarcotic adjunct analgesics, such as lidocaine and ketamine, in an acute-pain setting.

Opioid analgesics are the first-line treatment for acute pain from burns, despite increasing concern about the risk of opioid dependence after an operation, injury, or trauma. Although the risk of patients chronically using opioids after trauma or surgery is currently low (with

[Presentation title: High Risk of Developing Long-Term Opioid Use After Burn Injury]