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In the study of 142,089 Medicare patients with osteoarthritis who underwent total knee replacement surgery and had no history of high-dose opioid use, 10.6% became persistent users of high-dose opioids after surgery.

Certain preoperative characteristics including demographics (age, sex, and race), history of substance abuse (opioids, alcohol, and tobacco), and medication use (benzodiazepines, anxiolytics, antidepressants, anticonvulsants, and nonsteroidal anti-inflammatory drugs) were predictors of persistent use of high-dose opioids after surgery. 

“We believe that our prediction model may help identify patients at high risk of future adverse outcomes from persistent opioid use and dependence after total knee replacement surgery,” said senior author Seoyoung C. Kim, MD, ScD, MSCE, of Brigham and Women’s Hospital and Harvard Medical School.