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Research Letter
June 5, 2019

New Persistent Opioid Use After Postoperative Intensive Care in US Veterans

Author Affiliations
  • 1Department of Anesthesiology and Perioperative Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
  • 2The Patient Safety Center of Inquiry, Durham VA Healthcare System, Durham, North Carolina
  • 3Critical Care And Perioperative Epidemiologic Research Unit, Department of Anesthesiology, Duke University Health System, Durham, North Carolina
  • 4Department of Public Health Sciences, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania
JAMA Surg. 2019;154(8):778-780. doi:10.1001/jamasurg.2019.0899

New persistent opioid use was recently described as the most common postoperative complication after surgery in the United States.1 Less is known about the extent to which this problem occurs after intensive care unit (ICU) care, a setting where opioid use is common and considerable proportions of patients receive opioid prescriptions at discharge.2 Persistent opioid use may be a part of the post–intensive care syndrome, a syndrome of cognitive, psychiatric, and/or physical disability after treatment in an ICU.3 In this study, we measure new persistent opioid use in patients discharged after postoperative intensive care within the Veterans Health Administration. We also report changes over time and values before and after 2013, when both the initiation of the Veterans Health Administration Opioid Safety Initiative (OSI) and release of pain, agitation, and delirium (PAD) guidelines for patients with critical illness occurred.4,5

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