New research reported in The Journal of Pain shows the strongest predictive factors for prolonged opioid use after a traumatic musculoskeletal injury and surgery are pain severity and a poor sense of control over pain.

Scientists from the University of Toronto, York University and other Canadian centers hypothesized that pain severity measured in the hospital within two weeks of a musculoskeletal injury could predict use of prescription opioids four months after discharge. They also explored weather psychological distress would predict opioid use as much or more than pain severity.

Previous research has shown that people who sustain traumatic injuries are at higher risk than the general population for using and abusing opioids. Several studies have identified risk factors for persistent opioid use, such as a history of drug or alcohol abuse and taking medications for depression and anxiety. However, the extent that acute post-surgical pain and chronic pain influence persistent opioid use is not clear.

Results of the study, which employed secondary data analysis, showed that 35 percent of 122 patients reported using a prescription opioid for pain relief four months following a traumatic musculoskeletal injury requiring surgery. These patients had significantly greater pain severity and pain interference scores than patients who were not using opioids.

The study results support the hypothesis that initial in-hospital pain severity would predict use of prescription opioids four months after surgery. The data strongly suggest that pain severity and poor sense of pain control, not psychological distress, are the main factors associated with prolonged opioid use following musculoskeletal trauma and surgery.