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Evidence Library · The first hours

Opioids and the small but real risk of lasting use

Most women stop. A few do not.

Among 80,127 women who had never used opioids before their cesarean, 0.36% went on to persistent use, roughly 1 in 300. In a national cohort of 988,036 women, new persistent opioid use occurred in 2.2% of women who filled a prescription after cesarean and 1.7% after vaginal birth.

Most women use far fewer tablets than they are given. In a prospective study of 398 women prescribed 30 tablets, the median used over 14 days was 8, and 23.5% used none at all after discharge.

Two practical stepsAsk for a smaller prescription. And ask how to dispose of what you do not use, rather than leaving it in a cabinet.

Where this comes from

  1. Bateman BT, Franklin JM, Bykov K, Avorn J, Shrank WH, Brennan TA, et al. Persistent opioid use following cesarean delivery: patterns and predictors among opioid-naïve women. Am J Obstet Gynecol. 2016;215(3):353.e1-353.e18.
  2. Peahl AF, Dalton VK, Montgomery JR, Lai YL, Hu HM, Waljee JF. Rates of new persistent opioid use after vaginal or cesarean birth among US women. JAMA Netw Open. 2019;2(7):e197863.
  3. Osmundson SS, Halvorson A, Graves KN, Wang C, Bruehl S, Grijalva CG, et al. Development and validation of a model to predict postdischarge opioid use after cesarean birth. Obstet Gynecol. 2022;139(5):888-897.

Covered in the class

8Module 8. After: pain relief, the record, and what stays with youPain relief after birth is not given equally, and the record does not always match what happened.

Continue

Read this inside the full program, with the questions to take to your next visit and a record of what you have covered.

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