Opioid Pain Medication Use After Dermatologic Surgery: A Prospective Observational Study of 212 Dermatologic Surgery Patients | Dermatology | JAMA Dermatology | JAMA Network
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Manchikanti L, Fellows B, Ailinani H, Pampati V. Therapeutic use, abuse, and nonmedical use of opioids: a ten-year perspective.  Pain Physician. 2010;13(5):401-43520859312PubMedGoogle Scholar
Warner M, Chen LH, Makuc DM. Increase in fatal poisonings involving opioid analgesics in the United States, 1999-2006.  NCHS Data Brief. 2009;(22):1-819796521PubMedGoogle Scholar
 News release: Rx drug deaths back on the rise in Utah: prescription drug overdoses still kill more Utahns than car crashes (April 28, 2010). Utah State Publications website. http://statepubs.blogspot.com/2010_04_01_archive.html. Accessed August 30, 2011
Centers for Disease Control and Prevention (CDC).  Adult use of prescription opioid pain medications—Utah, 2008.  MMWR Morb Mortal Wkly Rep. 2010;59(6):153-15720168293PubMedGoogle Scholar
Firoz BF, Goldberg LH, Arnon O, Mamelak AJ. An analysis of pain and analgesia after Mohs micrographic surgery.  J Am Acad Dermatol. 2010;63(1):79-8620542176PubMedGoogle ScholarCrossref
Rogers HW, Weinstock MA, Harris AR,  et al.  Incidence estimate of nonmelanoma skin cancer in the United States, 2006.  Arch Dermatol. 2010;146(3):283-28720231499PubMedGoogle ScholarCrossref
Sniezek PJ, Brodland DG, Zitelli JA. A randomized controlled trial comparing acetaminophen, acetaminophen and ibuprofen, and acetaminophen and codeine for postoperative pain relief after Mohs surgery and cutaneous reconstruction.  Dermatol Surg. 2011;37(7):1007-101321561527PubMedGoogle ScholarCrossref
Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between smoking and low back pain: a meta-analysis.  Am J Med. 2010;123(1):87.e7-87.e3520007994PubMedGoogle ScholarCrossref
Pan PH, Coghill R, Houle TT,  et al.  Multifactorial preoperative predictors for postcesarean section pain and analgesic requirement.  Anesthesiology. 2006;104(3):417-42516508387PubMedGoogle ScholarCrossref
Affleck AG. Predicting pain during and after Mohs micrographic surgery: the need to consider psychological factors.  J Am Acad Dermatol. 2011;64(4):78821414502PubMedGoogle ScholarCrossref
Landau R, Kraft JC, Flint LY,  et al.  An experimental paradigm for the prediction of post-operative pain (PPOP).  J Vis Exp. 2010;(35):167120107427PubMedGoogle Scholar
March 2013

Opioid Pain Medication Use After Dermatologic Surgery: A Prospective Observational Study of 212 Dermatologic Surgery Patients

Author Affiliations

Author Affiliations: Saltzer Medical Group, Nampa, Idaho (Dr Harris); and Department of Dermatology, University of Utah, Salt Lake City (Drs Harris, Curtis, Duffy, Bowen, Hadley, and Tristani-Firouzi, Ms Larsen, and Mr Calder).


JAMA Dermatol. 2013;149(3):317-321. doi:10.1001/jamadermatol.2013.1871

Objective To better understand postoperative opioid use after dermatologic surgery.

Design Prospective observational study.

Setting Academic dermatology department.

Patients The study included 212 adults (1) who were undergoing a single skin excision (including Mohs micrographic surgery), (2) who consented to participate, and (3) who were able to be reached by telephone on postoperative day 3 or 4. Patients who did not meet these criteria and those referred to another physician for further surgical treatment or repair were excluded.

Main Outcome Measures The study examined (1) the incidence of opioid prescription after dermatologic surgery, (2) the percentage of prescribed opioid pain medications used in the postoperative period, and (3) patient and surgical characteristics associated with opioid pain medication prescription and use.

Results Opioids were prescribed to 72 of the 212 patients (34%). Twenty-five of the 72 patients (35%) who were prescribed opioids did not use them. Forty-nine of 57 patients (86%) who filled an opioid prescription had leftover pills, and 26 of the 49 patients (53%) planned to keep them. Only maximum pain score was significantly associated with opioid use.

Conclusions Opioids were overprescribed after dermatologic surgery. Patients who had leftover opioids did not dispose of them properly, which could lead to potential misuse and abuse.