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Scientific Oral Presentation

Facial Plastic and Reconstructive Surgery

Persistent Opioid Use Patterns Following Facial Trauma

Sunday, October 18, 2026

9:48 AM - 9:54 AM PT

Location: 404 A

Co-Author(s)

VK

Veenadhari Kollipara, n/a

Medical Student
Penn State College of Medicine
Hershey, Pennsylvania, United States
FL

F. Jeffrey F. Lorenz, MD

Resident Physician, Otolaryngology–Head and Neck Surgery
Penn State University
Hershey, PA, United States

Senior Author(s)

Jessyka G. Lighthall, MD FACS

Chief, Division of Facial Plastic and Reconstructive Surgery Professor, Department of Otolaryngology
Milton S. Hershey Medical Center / Penn State College of Medicine
Hershey, PA, United States

Presenting Author(s)

Kunal A. Koka, BS

Medical Student
Penn State College of Medicine
Hershey, PA, United States

Disclosure(s):

Kunal A. Koka, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Opioid prescriptions are a significant contributor to the ongoing opioid epidemic with acute trauma serving as a common initial exposure point. Despite guidelines emphasizing opioid stewardship, opioid prescribing patterns following facial trauma are poorly understood. The aim of this study is to determine the risk of persistent opioid use in facial trauma patients and identify risk factors for persistent opioid use.

Methods: The TriNetX database was queried for adult patients who suffered fractures of their nasal bones, orbital floor, maxilla, zygomatic, mandible, or other facial bones between 2013-2023. Four cohorts were generated based on opioid prescriptions in the post-fracture period (≤ 1month): any opioid medications, oxycodone/hydrocodone, tramadol, and no opioid analgesics. Exclusion criteria included patients who received surgery for their fracture, patients who received other surgery, anesthesia, or additional fractures 1-12 months after their facial fracture, and patients with history of opioid abuse or opioid prescription 1 day - 1 year before their fracture. Cohorts were propensity score matched for age, sex, race, and ethnicity. The primary outcome was persistent opioid use, defined as an additional opioid prescription 1-12 months after their facial trauma.

Results: We identified 30,233 patients in the any opioids cohort, 19,862 in the oxycodone/hydrocodone cohort, 2,197 in the tramadol cohort, and 66,031 in the no opioid analgesics cohort. Patients prescribed any opioids in the post-fracture period had a significantly higher risk of persistent opioid use compared to the no opioid cohort (Risk Ratio (RR): 2.12, 95% confidence interval (CI): 2.00-2.26, p< 0.0001). The tramadol cohort showed a higher risk of persistent opioid use compared to the oxycodone/hydrocodone cohort (RR: 1.77, 95% CI: 1.46-2.15, p< 0.0001).

Conclusions: Post-fracture opioid prescription results in a higher risk of persistent opioid use, highlighting the need for judicious opioid prescribing in facial trauma patients to prevent dependency. Future studies are needed to elucidate optimal non-opioid regimen.