Common cardiac device implants and persistent opioid use overlap

A new study from Penn Medicine shows that about 12% of patients who receive implantable cardiac devices continue taking pain medication in the months afterward.

About 12% of patients who receive implantable cardiac devices such as a pacemaker or defibrillator and fill an opioid prescription after surgery will consistently use the pain medication in the months afterward, raising the potential for addiction following these common procedures and identifying another pathway that could contribute to the national opioid crisis, according to a new study by researchers at the Perelman School of Medicine. The findings are published in Circulation.

White pills in a pile.

Using data from a national insurance-claims database of adult patients undergoing cardiac implantable electronic device procedures from 2004 to 2018, the Penn researchers found that, of their sample of 143,400 patients, 15,316 patients filled an opioid prescription within two weeks of surgery. Of those patients, persistent opioid use—defined as filling another opioid prescription between one and six months after the procedure—occurred in 1,901 patients (who did not have a history of opioid use), or 12.4%, compared to 5.4% of patients without an initial opioid prescription.

“Even a small number of oxycodones can start the addiction process,” says senior author David S. Frankel, an associate professor of cardiovascular medicine and director of the Cardiac Electrophysiology Fellowship Program at Penn. “The significance of this study is to make other electrophysiologists aware that even a low-risk procedure like a pacemaker or a defibrillator can lead to chronic opioid use and that physicians may want to be more conservative in prescribing opioids after surgery.”

Read more at Penn Medicine News.