Post-surgery opioids ‘over-prescribed’ in NZ

New Zealand’s healthcare providers are over-prescribing opioids to patients post-surgery, potentially fuelling addiction, a new study has found.

The student-led Tasman Collaborative’s study, 'Opioid prescriptions and usage after surgery' (Operas), found opioids are being prescribed at twice the amount being consumed by patients in the week following surgery. Although the surplus did not improve pain management, it did increase the risk of side effects and dependency, they said.

The results of the study showed the quantity of opioids prescribed to patients at discharge from Middlemore and Whangarei Hospitals to be independently linked with a 30% increase in opioid consumption, said Dr Chris Varghese, an Auckland University honorary lecturer and junior doctor at Middlemore. The study’s 1,311 patients underwent 19 common surgeries and were prescribed a median of 10 tablets of 10mg Sevredol (morphine sulfate). Seven days after surgery, a median of just four tablets had been consumed. Dr Varghese said the 19 surgeries did not include ophthalmological surgery.

In 2021, 46 of New Zealand’s 171 drug deaths were thought to be from opioid overdose, reported the New Zealand Drug Foundation. Dr Varghese told The New Zealand Herald the over-prescription of opioids is not a problem isolated to the US, it’s an issue in Aotearoa too.

Heading for a US-style opioid epidemic?

A New Zealand anaesthesiologist (who preferred not to be named) told NZ Optics the US system is more conducive to opioid addiction than the one here. “In the US, (patients) can pick and choose and go to where ratings are best. So physicians give a bucket of opioids to everyone to avoid being rated badly for having sore patients… in New Zealand you go local and have no choice, so we have quite different drivers of care.” Kiwi patients also better understand and expect a certain level of pain with some conditions, unlike US patients, said the anaesthesiologist.

Auckland University’s Jay Gong, whose PhD research is on post-hospitalisation opioid use, said that in New Zealand strong opioids such as morphine and oxycodone are prescribed on a special triplicate prescription with no charge and limited to a maximum 10-day supply. “This means no matter where in the country the patient is dispensed an opioid, the relevant information will be reported to the Ministry.” New Zealanders’ persistent opioid use is comparable to those in other developed countries, said Gong. “One in eight may become a new persistent opioid user, with no prior opioid use.”

Opioid analgesic use has more than doubled worldwide between 2001-2003 and 2011-2013, with notable substantial increases in North America, Western and Central Europe and Oceania, according to a global study by The Lancet by Berterame et al.

*For the full OPERAS study, click here.