Opioid Dependence Leads to Complications after Heart Surgery

Chronic opioid use has dramatically increased in the U.S. in recent years, and so has the number of people with opioid dependence needing life-saving heart surgery. Now, new research is showing that those with opioid dependence have a greater risk of major complications following heart surgery.

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CLEVELAND – Chronic opioid use has dramatically increased in the U.S. over the past two decades.

Likewise, the number of people with opioid dependence needing life-saving heart surgery has also increased.

Now, new research is looking at whether those with opioid dependence face greater health risks when undergoing heart surgery.

The study looked at 5.7 million patients – who had heart surgery between 1998 and 2013 and identified a little under 12,000 people within that group with opioid dependence.

“We found that patients with chronic opioid use had no increase in mortality of heart surgery of various different types, so cardiac surgery was safe in that population, however, these patients had a higher risk of complications,” said Cleveland Clinic’s Edward Soltesz, M.D., who led the research.

Study results showed that following heart surgery, patients with chronic opioid use had a heightened risk of major complications including blood transfusion, pulmonary embolism, mechanical ventilation and prolonged post-surgery pain.

Results also showed that the number of heart surgery patients with chronic opioid use had an eight-fold increase over 15 years.

Dr. Soltesz said because of the major complications that can arise for these individuals, they often have longer hospital stays following heart surgeries.

During the course of the study, Dr. Soltesz said researchers learned that many people across the country are denied surgery based on their opioid dependence.

“As a patient, if you do have chronic opioid use, and you’re denied surgery, you should seek a second opinion,” he said. “I think that’s very important because our data shows that cardiac surgery is safe for these individuals.”

Dr. Soltesz said because of the increased risks, as shown by this research, individuals with chronic opioid use should not only find a  hospital that can accommodate them, but also develop a plan to try to eliminate opioid use prior to having surgery.

“It’s important to work with your primary care doctor, or a chronic pain doctor, to try to come off some of these chronic opioids before surgery,” he said.

Dr. Soltesz said it’s also important that following any surgery, whether major or minor, to know that opioids should not be used for long-term care.

Research has shown there are other methods to treat chronic pain that are more effective that don’t come with the risks of opioids.

Complete results of the study can be found in JAMA Surgery.

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