Secondary Logo

Institutional members access full text with Ovid®

Persistent Opioid Use and High-Risk Prescribing in Body Contouring Patients

Bennett, Katelyn G., M.D., M.S.; Kelley, Brian P., M.D.; Vick, Alexis D., B.S.; Lee, Jay S., M.D.; Gunaseelan, Vidhya, M.S., M.H.A.; Brummett, Chad M., M.D.; Waljee, Jennifer F., M.D., M.S.

Plastic and Reconstructive Surgery: January 2019 - Volume 143 - Issue 1 - p 87-96
doi: 10.1097/PRS.0000000000005084
Cosmetic: Original Articles
Journal Club
Patient Safety CME
Psychosocial Insights

Background: Opioid misuse occurs commonly among obese patients and after bariatric surgery. However, the risk of new persistent use following postbariatric body contouring procedures remains unknown.

Methods: The authors examined insurance claims from Clinformatics Data Mart (OptumInsight, Eden Prairie, Minn.) between 2001 and 2015 for opioid-naive patients undergoing five body contouring procedures: abdominoplasty/panniculectomy, breast reduction, mastopexy, brachioplasty, and thighplasty (n = 11,257). Their primary outcomes included both new persistent opioid use, defined as continued prescription fills between 90 and 180 days after surgery, and the prevalence of high-risk prescribing. They used multilevel logistic regression to assess the risk of new persistent use, adjusting for relevant covariates.

Results: In this cohort, 6.1 percent of previously opioid-naive patients developed new persistent use, and 12.9 percent were exposed to high-risk prescribing. New persistent use was higher in patients with high-risk prescribing (9.2 percent). New persistent use was highest after thighplasty (17.7 percent; 95 percent CI, 0.03 to 0.33). Increasing Charlson comorbidity indices (OR, 1.11; 95 percent CI, 1.05 to 1.17), mood disorders (OR, 1.27; 95 percent CI, 1.05 to 1.54), anxiety (OR, 1.41; 95 percent CI, 1.16 to 1.73), tobacco use (OR, 1.22; 95 percent CI, 1.00 to 1.49), neck pain (OR, 1.23; 95 percent CI, 1.04 to 1.46), arthritis (OR, 1.30; 95 percent CI, 1.08 to 1.58), and other pain disorders (OR, 1.36; 95 percent CI, 1.16 to 1.60) were independently associated with persistent use.

Conclusions: Similar to other elective procedures, 6 percent of opioid-naive patients developed persistent use, and 12 percent were exposed to high-risk prescribing practices. Plastic surgeons should remain aware of risk factors and offer opioid alternatives.


This and Related “Classic” Articles Appear on for Journal Club Discussions.Patient Safety CME.Psychosocial Insights for This Article are on Page 94.

Ann Arbor, Mich.; and Toledo, Ohio

From the Section of Plastic Surgery, Departments of Surgery and Orthopedic Surgery, the Section of General Surgery, Department of Surgery, the Department of Anesthesiology, University of Michigan; and the University of Toledo School College of Medicine and Life Sciences.

Received for publication January 11, 2018; accepted July 13, 2018.

Disclosure:Dr. Bennett is currently supported by the National Institute of Dental and Craniofacial Research (1F32DE027604-01). Dr. Waljee is supported by Michigan Department of Health and Human Services (MDHHS) (E20180672-00). No other financial relationships to disclose.

By reading this article, you are entitled to claim one (1) hour of Category 2 Patient Safety Credit. ASPS members can claim this credit by logging in to Dashboard, clicking “Submit CME,” and completing the form.

Supplemental digital content is available for this article. Direct URL citations appear in the text; simply type the URL address into any Web browser to access this content. Clickable links to the material are provided in the HTML text of this article on the Journal’s website (

Jennifer F. Waljee, M.D., M.S., Taubman 2130, 1500 East Medical Center Drive, Ann Arbor, Mich. 48109, Twitter: @waljeejenn

Copyright © 2018 by the American Society of Plastic Surgeons