New chronic opioid use in Medicaid patients following cholecystectomy

Commercial insurance data show that chronic opioid use in opioid-naive patients occurs in 1.5% to 8% of patients undergoing surgical procedures, but little is known about patients with Medicaid. Opioid prescription data and medical coding data from 4,788 Medicaid patients who underwent cholecystectomy were analyzed to determine opioid use patterns. A total of 54.4% of patients received opioids prior to surgery, and 38.8% continued to fill opioid prescriptions chronically; 27.1% of opioid-naive patients continued to get opioids chronically. Patients who received ≥50 MME/d had nearly 8 times the odds of chronic opioid use. Each additional opioid prescription filled within 30 days was associated with increased odds of chronic use (odds ratio: 1.71). Opioid prescriptions are common prior to cholecystectomy in Medicaid patients, and 38.8% of patients continue to receive opioid prescriptions well after surgical recovery. Even 27.1% of opioid-naive patients continued to receive opioid prescriptions chronically. •A total of 54.4% of cholecystectomy Medicaid patients received opioids prior to surgery.•Nearly 40% continued to fill opioid prescriptions chronically.•Among opioid-naive patients, 27.1% continue to receive opioids after typical recovery from surgery.•Patients receiving ≥50 MME/d 30 days after surgery had 8 times the odds of chronic opioid use.•Each additional opioid prescription was associated with increased odds of chronic use (odds ratio: 1.71).