# Use of Prescription Opioids Following Surgery and Associated Adverse Patient Outcomes in Older Adults

> **NIH NIH R56** · HARVARD MEDICAL SCHOOL · 2020 · $677,465

## Abstract

Project Summary/Abstract
 Rates of opioid prescribing and opioid-related overdose deaths have quadrupled in the United States over
the past 25 years. This epidemic has increasingly affected older adults, among whom hospitalization rates for
opioid overdoses grew five-fold from 1993-2012. Risks of opioid use are particularly pronounced for older
adults, who are vulnerable to opioids’ side effects. Although substantial attention has been placed on
inappropriate prescribing of opioids, the ways in which opioid-naïve patients develop long-term opioid use are
mostly unknown. One of the most common settings for older adults to receive opioids is after surgery. The
period after surgery is a particularly vulnerable one for opioid use, both because of older adults’ clinical fragility
after surgery and because the post-hospitalization period often involves a highly fragmented transition of care.
However, little data exist on the extent to which opioids are prescribed following surgery among older adults,
surgeries for which prescribing and opioid-related adverse events are most common, and the role of surgeon-
and hospital-level factors in contributing to short- and long-term prescription opioid use.
 Many argue that variation in physician prescribing behavior has been a driver of the opioid epidemic.
However, no research has explored the extent to which individual surgeons vary in opioid prescribing following
surgery and the implications of that variation for patients’ long-term opioid use and related adverse outcomes.
In addition, little research has examined whether intra- and post-operative pain management techniques such
as regional anesthesia, which may reduce pain following surgery, may also reduce long-term opioid use and
related adverse outcomes after surgery.
 The proposed research will quantify the short- and long-term effects of opioid prescribing following surgery
– including short-term opioid-related adverse events and the transition to long-term use – among previously
opioid-naïve older adults who undergo inpatient surgery using Medicare administrative claims. Because a key
challenge in identifying the effect of surgeons in contributing to short- and long-term opioid use after
hospitalization is separating the effects of provider practice patterns from unobservable patient characteristics
that affect opioid use, the proposed research will develop novel quasi-experimental approaches that rely on
quasi-random assignment of hospitalized Medicare beneficiaries to providers of varying opioid-prescribing
intensity. The proposed research will also develop quasi-experimental methods to study how different
approaches to pain management during surgery (use of regional anesthesia) influence post-operative opioid
use and potentially downstream opioid-related adverse outcomes.
 Results from this research will help define the risks of post-operative opioid use among older adults and
can inform the need, design and potential impact of policies that target ...

## Key facts

- **NIH application ID:** 10017798
- **Project number:** 5R56AG059620-02
- **Recipient organization:** HARVARD MEDICAL SCHOOL
- **Principal Investigator:** Anupam Bapu Jena
- **Activity code:** R56 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $677,465
- **Award type:** 5
- **Project period:** 2019-09-15 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10017798

## Citation

> US National Institutes of Health, RePORTER application 10017798, Use of Prescription Opioids Following Surgery and Associated Adverse Patient Outcomes in Older Adults (5R56AG059620-02). Retrieved via AI Analytics 2026-05-29 from https://api.ai-analytics.org/grant/nih/10017798. Licensed CC0.

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