Effect of opioid dependence or abuse on opioid utilization after shoulder arthroplasty

Table 1 Generic drug codes for opioid medications tracked in the current study

Opioid medication	Generic drug codes
Oxycodone	101126, 101215, 106757, 108546, 111094, 107000, 109518, 100548, 100504, 110286, 109192, 106437
Hydrocodone	106414, 112157, 101854, 100055, 110070, 105295, 112625, 102382, 101434, 109398, 110812, 100358, 101802, 108359, 106104, 106326, 106622, 107601, 103995, 111636, 106030, 106747, 101805, 110605, 108113, 112007
Morphine sulfate	104592, 106367, 108034, 104962, 100074, 103380, 108114, 110174, 112832
Codeine	101623, 100873, 107990, 103275, 104787, 104710, 107214, 112297, 104491, 112574, 112774, 108218, 101073, 107402, 103943, 107406, 104952, 108825, 102621, 110215, 101274, 109769, 105010, 105460, 111188, 107202, 112555, 104895, 108556, 102273, 107506, 110492, 110760, 112140, 107410, 103069, 109078, 101383, 109320, 104915, 112523, 100351, 111016, 108443, 106918, 105070, 104040, 109446, 111749, 108445, 108480, 112775, 105654, 110799, 109752, 100679, 109086, 108889, 110743, 106810, 102890, 110671
Fentanyl	100599, 104678, 101119, 103260, 100142
Hydromorphone	101111, 100978
Meperidine	101505, 101784, 112026
Methadone hydrochloride	100319
Oxymorphone hydrochloride	101242

Table 2 Patients receiving a brachial plexus block on the day of surgery n (%)

	With pre-op opioid dependence/abuse	Without pre-op opioid dependence/abuse	P-value
TSA	92 (58.60)	4105 (53.44)	0.199
RSA	108 (52.43)	3461 (51.55)	0.803

TSA: Total shoulder arthroplasty; RSA: Reverse shoulder arthroplasty.

Table 3 Relative risk of opioid utilization at post-operative intervals for patients with vs without a history of opioid dependence/abuse

	TSA			RSA
Post-operative interval	RR	95%CI	P value	RR	95%CI	P value
0-1 mo	1.14	1.04-1.25	0.005	1.36	1.27-1.45	< 0.001
1-2 mo	2.25	1.97-2.56	< 0.0001	2.28	2.06-2.53	< 0.001
2-3 mo	2.78	2.42-3.20	< 0.0001	2.69	2.40-3.02	< 0.001
3-4 mo	2.80	2.39-3.27	< 0.0001	3.20	2.85-3.60	< 0.001
4-5 mo	2.78	2.34-3.30	< 0.0001	3.23	2.82-3.69	< 0.001
5-6 mo	2.84	2.38-3.40	< 0.0001	3.09	2.67-3.57	< 0.001
6-7 mo	3.00	2.54-3.56	< 0.0001	3.26	2.82-3.75	< 0.001
7-8 mo	2.87	2.40-3.43	< 0.0001	3.34	2.87-3.88	< 0.001
8-9 mo	2.88	2.39-3.46	< 0.0001	3.30	2.83-3.85	< 0.001
9-10 mo	2.90	2.39-3.52	< 0.0001	3.47	2.95-4.08	< 0.001
10-11 mo	2.81	2.30-3.44	< 0.0001	3.50	2.98-4.10	< 0.001
11-12 mo	2.97	2.44-3.61	< 0.0001	3.36	2.83-3.98	< 0.001

TSA: Total shoulder arthroplasty; RSA: Reverse shoulder arthroplasty.

Table 4 Analysis of risk factors for pre-operative opioid dependence/abuse

	TSA			RSA
Variable	RR	95%CI	P value	RR	95%CI	P value
Female	1.07	0.78-1.46	0.691	1.3	0.96-1.75	0.085
Age < 65	2.12	1.46-3.08	0.000	1.6	1.06-2.41	0.024
Mood disorder	6.70	4.92-9.11	< 0.0001	5.27	4.04-6.87	< 0.0001
Chronic pain	10.31	7.51-14.17	< 0.0001	10.10	7.53-13.57	< 0.0001

TSA: Total shoulder arthroplasty; RSA: Reverse shoulder arthroplasty.