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This paper suggests that prescribing opioids after surgery leads to opioid use disorder (OUD) among some who are exposed. However, it would be helpful to know what proportion of those who did not receive an opioid prescription were subsequently diagnosed with OUD. The rate of OUD among those who received an opioid prescription (about 1%) is comparable to the rate in the general population in the US; the important question is to what extent (if any) is this rate higher than those who were not prescribed. The authors focus on the fact that receiving refills was associated with a higher risk of OUD, but this may simply be a marker for those with an unrecognized OUD prior to surgery or a susceptibility to OUD after exposure.
No competing interests
02 February 2018
Darius A. Rastegar
Johns Hokins University School of Medicine
Johns Hopkins Bayview Medical Center, 5200 Eastern Avenue, Baltimore MD 21224