Predictors of postoperative opioid use in NCAA Division 1 collegiate athletes

Abstract Background With the growing severity of the opioid epidemic in the United States, it is increasingly important for surgeons to understand the opioid requirements of their patients, especially in the population of collegiate athletes. The purpose of this study is to determine variables influencing the quantity of total morphine milligram equivalents (TMEs) and percent of prescribed TMEs used following surgery in Division 1 collegiate athletes. Methods A consecutive cohort of 25 Division 1 collegiate athletes from one institution undergoing knee or shoulder surgery at a single hospital for sport-related injuries between December 2016 and December 2018 were retrospectively identified. A regional prescription drug monitoring program was used to verify discharge medications. Patients were instructed to bring their unused pills to a follow-up visit 2–4 days after surgery. The amount of opioids prescribed and used was standardized using morphine conversion factors to determine milligram morphine equivalents. TMEs Used was determined by summing the amount of morphine equivalents the patients used of their discharge opioids. The Percent of TMEs Used was determined by dividing the amount of TMEs used by the amount of TMEs prescribed at discharge. Demographic variables and other regulated prescriptions were also recorded. Bivariate and multivariate analyses were used to determine variables that influence and/or predict the amount of TMEs Used and Percent of TMEs Used. Results Multivariable regression found that a history of non-analgesic controlled substance use (p = 0.027) and the amount of TMEs prescribed at discharge (p  Conclusions Providers for Division I collegiate athletes should carefully consider a patient’s nonanalgesic controlled substance history, comorbidities, and prescribed opioid burden when planning a postoperative pain management course.