Persistent Opioid Use Following Resection of Oral Cavity Squamous Cell Carcinoma: Incidence and Risk Factors.

Abstract

Persistent opioid use after head and neck cancer surgery is a growing concern, but data regarding incidence and risk factors remain limited. This retrospective cohort study included patients who underwent primary resection of oral cavity squamous cell carcinoma between 2016 and 2022. Preoperative opioid use was classified as naïve, intermittent, or chronic using prescription drug monitoring data. Persistent use was defined as filling an opioid prescription attributed to surgery and two consecutive prescriptions between 120 and 365 days postoperatively. Regression analysis identified independent predictors. Among 430 subjects, 18.8% met criteria for persistent opioid use. Chronic preoperative use (p = 0.008), G-tube persistence at 12 months (p = 0.041), chronic pain diagnosis (p = 0.036), and cancer recurrence (p = 0.021) were independent predictors. Persistent use peaked between 120 and 180 days postoperatively. Persistent opioid use is common after oral cancer resection and is strongly associated with preoperative opioid use. Early risk stratification may improve outcomes.