The University of Michigan’s Opioid Research Institute received a $3.3 million grant last month from the National Institute on Drug Abuse to fund a 5-year research project regarding surgical care for patients with opioid use disorder. Those diagnosed with OUD are individuals who chronically use opioids in a way that negatively impacts their mental and physical health. This study is the first national study to record the levels of medications for opioid use disorder after surgery to determine how they are retained.
In a statement released by the School of Public Health, Mark Bicket, co-principal investigator of the grant, said the grant will fund research that addresses key knowledge gaps in the ORI’s understanding of how to best support surgical patients with OUD.
“Findings from this study will advance guidelines on treating pain after surgery for persons with opioid use disorder from expert opinion to evidence-based medicine, and reduce opioid-related morbidity and mortality following surgery,” Bicket said.
In an interview with The Daily, co-investigator of the grant Pooja Lagisetty said the study aims to gain a better understanding of how MOUDs affect patients with OUD who need surgery, as well as how frequently those using MOUD need surgery.
“What this proposal is aiming to do is to try to get an understanding of how often people who are on (MOUD) are even having surgical procedures, but (also) trying to figure out, more importantly, when they have those surgical procedures, how does that kind of acute perioperative time impact their ability to stay on these evidence-based treatments,” Lagisetty said.
Currently, patients with OUD might be prescribed medications for opioid use disorder, which act as opioid agonists to block the receptors that opioids interact with and reduce withdrawal symptoms. MOUDs include buprenorphine, methadone and naltrexone. In an interview with The Michigan Daily, Thuy Nguyen, the project’s co-principal investigator, said there is debate over whether patients prescribed MOUD should continue to use them when recovering from surgery.
“The reason to stop (taking MOUD) before surgery is to make sure the traditional opioids can have full effects in pain relief,” Nguyen said. “But the reason for still continuing this medication is that if the patient stops taking (MOUD), then they might have a relapse and they might continue using opioids and may overdose.”
According to Nguyen, the study will have an observational design and will analyze existing data on OUD treatment and post-surgery health outcomes from large national databases.
“(The study will look at data) across payer types including Medicaid claims data, Medicare claims data and national commercial insurance data to examine the treatment patterns and health outcomes after surgery,” Nguyen said. “So in order to provide evidence from our observational research, we need to apply a rigorous quantitative approach to address potential confounding bias.”
Rates of death due to opioid overdose in the United States had an 18% increase from 2020 to 2021, with 79,770 opioid-involved deaths in 2022. Nguyen said she wishes more Americans understood the heavy toll of OUD.
“I think a lot of people maybe underestimate the prevalence of this issue,” Nguyen said. “According to a recent national survey, there is an estimated 9.2 million people in the U.S. (who) misuse opioids.”
Lagisetty said research into surgical care for those with OUD is important because the disorder is a growing public health crisis and those with the disease often experience stigmatization.
“Much like any other medical condition that people deal with, like diabetes or hypertension, it can happen to anybody,” Lagisetty said. “It’s important for us to recognize it in that context and to not stigmatize it in a way that we wouldn’t think of doing with other medical conditions.”
Daily News Reporter Nadia Taeckens can be reached at taeckens@umich.edu.
Daily News Contributors Alexandra Nguyen and Brock McIntyre contributed to the reporting of this article.