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:
319. 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.
320. 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.
353. 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.
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