The Era of Opioids As the Gold Standard for Pain Management Is Over

The Majority of Surgical Patients Receive Opioids & Many Will Go On to Become Persistent Long-Term Users^1,2

While opioids have been a mainstay in postsurgical pain control, they are also at the center of an ongoing national crisis. For many patients undergoing surgery, it is their first exposure to opioids.

99% of Patients

receive opioids to manage postsurgical pain²*

1 out of 15 Surgical Patients

prescribed an opioid may go on to long‑term use or abuse^3,4†

An Estimated 1.1 Million Americans

will become persistent users of opioids each year following initial exposure after surgery in the hospital³

*In a retrospective study of hospital discharge data (N=37,301)^†In a prospective longitudinal study (N=109)

Newly Persistent Opioid Patients by Percentage

Overall, approximately 9.5% of surgical patients who had not been taking opioids prior to the perioperative period became newly persistent users in 2017.

Economic & Clinical Burdens of Opioid Use in Multiple Payer Channels in the United States¹

Study Background

Retrospective, observational cohort study of medical claims, healthcare utilization, and costs in opioid-naive patients who received and those who did not receive opioids after surgery in large, nationally representative claims databases

Patient Population

N=4,105,121
General, orthopedic, plastic, obstetric/gynecologic, and other surgery

Findings

Postsurgical opioid use resulted in increased total inpatient healthcare costs, increased inpatient and outpatient postsurgical pain, and increased outpatient admissions/readmissions

Total Healthcare Costs (Inpatient)

Bar chart comparing inpatient healthcare costs with and without opioids post-surgery across insurance types. Costs are consistently higher for patients who received opioids.

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Postsurgical Pain Within 90 Days

	Commercial Patients	Medicare  Patients	Medicaid  Patients
Opioids Postsurgery (Inpatient)	1.9%	2.5%	2.8%
No Opioids Postsurgery (Inpatient)	0.7%	1.2%	0.7%
Opioids Postsurgery (Outpatient)	7.6%	4.5%	6.5%
No Opioids Postsurgery (Outpatient)	1.8%	0.6%	1.8%

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Admission/Readmission Within 90 Days (Outpatient)

Bar chart showing higher 90-day outpatient readmission rates for patients who received opioids post-surgery across Commercial, Medicare, and Medicaid plans.

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There Are Risks Associated With Opioid Exposure

68% of People

using pain relievers (non-medically) obtained them from a friend or relative^7*

4 out of 5 New Heroin Users

started out by misusing opioids^8†

*According to the 2013 National Survey on Drug Use and Health among past-year users aged ≥12 years (N≈37,000)

^†From an analysis of the 2008-2010 National Surveys on Drug Use and Health to examine patterns of heroin use and risk behaviors among past-year non-medical users of opioid pain relievers

Most Patients Would Prefer a Non-Opioid Option to Control Their Pain After Surgery⁹*

~90% of Patients

said they were concerned about side effects of, addiction to, or dependence on opioids

79% of Patients

said they preferred a non-opioid pain management option

*From a survey of 500 adults in the United States who had an orthopedic or soft tissue surgery and 200 US surgeons who perform these procedures

References

Brummett CM, Waljee JF, Goesling J, et al. New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg. 2017;152(6):e170504. doi:10.1001/jamasurg.2017.0504
Kessler ER, Shah M, Gruschkus SK, Raju A. Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacotherapy. 2013;33(4):383-391.
Carroll I, Barelka P, Wang CKM, et al. A pilot cohort study of the determinants of longitudinal opioid use after surgery. Anesth Analg. 2012;115(3):694-702.
Alam A, Gomes T, Zheng H, Mamdani MM, Juurlink DN, Bell CH. Long-term analgesic use after low-risk surgery: a retrospective cohort study. Arch Intern Med. 2012;172(5):425-430.
Pacira Pharmaceuticals, Inc. United States for Non-Dependence: An Analysis of the Impact of Opioid Overprescribing in America. September 2017. [Analysis in the report was based on research conducted by the QuintilesIMS Institute.]
Brummett CM, England C, Evans-Shields J, et al. Health care burden associated with outpatient opioid use following inpatient or outpatient surgery. J Manag Care Spec Pharm. 2019;25(9):973-983. doi:10.18553/jmcp.2019.19055
Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, Substance Abuse and Mental Health Services Administration, 2014. NSDUH Series H-48, HHS Publication No. (SMA) 14-4863. Rockville, MD.
Jones CM. Heroin use and heroin use risk behaviors among nonmedical users of prescription opioid pain relievers—United States, 2002–2004 and 2008–2010. Drug Alcohol Depend. 2013;132(1-2):95-100.
New research: opioid addiction and dependence after surgery is significantly higher than previously known [news release]. Parsippany, NJ: Pacira Pharmaceuticals, Inc; August 1, 2016. https://investor.pacira.com/news-releases/news-release-details/new-research-opioid-addiction-and-dependence-after-surgery. Accessed March 10, 2025.