Burns : journal of the International Society for Burn Injuries · 2026
Burns and burden: The role of substance use disorders on prolonged opioid use and postoperative complications following head, neck, and facial burns.
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Lewis Joshua E, Anga Olivia, Patterson Jarrell, Alexander Chrishaun, Nuamah Derek, Kankam Jordan, Chowdhury Sheuli, Henderson Peter W
Аннотация
PURPOSE: Substance use disorders (SUD) are common among burn patients and may influence recovery, pain management, and postoperative complications. While prior studies have examined general predictors of burn outcomes, limited research has focused on SUD and region-specific injuries. This study evaluated the association between preexisting cannabis, tobacco, and alcohol use disorders and prolonged opioid use, wound infection, and postoperative pain in patients with head, neck, and facial burns.
METHODS: A retrospective cohort study was conducted using the TriNetX Research Network, comprising data from 109 healthcare organizations. Adult patients (≥18 years) with head, neck, or facial burns were included. Cohorts were stratified based on documented diagnoses of cannabis, tobacco, or alcohol use disorders prior to injury. Outcomes were assessed at one, three, and six months post-burn. Multivariable regression models were used to evaluate associations between SUD and prolonged opioid use, wound infection, and postoperative pain. Risk ratios (RRs), 95% confidence intervals (CIs), and p-values were reported, with statistical significance set at p < 0.05.
RESULTS: At all timepoints, cannabis (RR: 1.685-2.108), tobacco (RR: 1.722-2.51), and alcohol use disorders (RR: 1.878-2.239) were significantly associated with prolonged opioid use (p < 0.0001). Tobacco use disorder was the only SUD consistently associated with increased wound infection risk across all timepoints (RR: 2.043-2.51, p < 0.01). Cannabis and alcohol use disorders were not significantly associated with wound infection. Postoperative pain was significantly increased among patients with cannabis (RR: 1.973-2.108), alcohol (RR: 1.878-2.083), and tobacco use disorders (RR: 1.722-1.850).
CONCLUSION: Preexisting SUDs are associated with prolonged opioid use and increased postoperative pain following head, neck, and facial burns, while tobacco use disorder is additionally associated with higher wound infection risk. These findings highlight the need for tailored perioperative and pain management strategies in burn patients with SUD.
METHODS: A retrospective cohort study was conducted using the TriNetX Research Network, comprising data from 109 healthcare organizations. Adult patients (≥18 years) with head, neck, or facial burns were included. Cohorts were stratified based on documented diagnoses of cannabis, tobacco, or alcohol use disorders prior to injury. Outcomes were assessed at one, three, and six months post-burn. Multivariable regression models were used to evaluate associations between SUD and prolonged opioid use, wound infection, and postoperative pain. Risk ratios (RRs), 95% confidence intervals (CIs), and p-values were reported, with statistical significance set at p < 0.05.
RESULTS: At all timepoints, cannabis (RR: 1.685-2.108), tobacco (RR: 1.722-2.51), and alcohol use disorders (RR: 1.878-2.239) were significantly associated with prolonged opioid use (p < 0.0001). Tobacco use disorder was the only SUD consistently associated with increased wound infection risk across all timepoints (RR: 2.043-2.51, p < 0.01). Cannabis and alcohol use disorders were not significantly associated with wound infection. Postoperative pain was significantly increased among patients with cannabis (RR: 1.973-2.108), alcohol (RR: 1.878-2.083), and tobacco use disorders (RR: 1.722-1.850).
CONCLUSION: Preexisting SUDs are associated with prolonged opioid use and increased postoperative pain following head, neck, and facial burns, while tobacco use disorder is additionally associated with higher wound infection risk. These findings highlight the need for tailored perioperative and pain management strategies in burn patients with SUD.