Understanding Postoperative Persistent Opioid Use: A Qualitative Meta-Synthesis.

Abstract

Objectives: Worldwide, the clinical condition referred to as "new persistent opioid use" describes prolonged opioid use in the postoperative period. Long-term postoperative opioid use is associated with an increased risk of complications, opioid use disorder, overdose, and death. This study focuses on the subjective experiences of patients using opioids after surgery. The aim was to generate a nuanced understanding of the reasons for the continuation of postoperative opioid use and to elucidate how these experiences shape patients' perceptions, decision-making processes, and coping mechanisms.

Design: This study is a thematic meta-synthesis of qualitative research.

Data sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were followed, and the study was registered in PROSPERO (International Prospective Register of Systematic Reviews; CRD4202661291520). The literature search was conducted on January 25, 2026. To identify relevant literature, MEDLINE, Web of Science (WOS), PubMed, EBSCO, Cochrane, Scopus, and Google Scholar were systematically searched, and studies meeting the inclusion criteria were selected.

Review/analysis methods: Study data were analyzed in accordance with Thomas and Harden's three-stage thematic synthesis approach.

Results: This meta-synthesis was conducted by analyzing eight qualitative studies carried out in four different countries, encompassing findings from a total of 310 patients who met the inclusion criteria. As a result of the analysis, four main themes and 12 subthemes were identified regarding surgical patients' experiences with pain and opioid use.

Conclusion: The synthesis of the studies included in this research reveals patients' experiences with postoperative pain and opioid use. It demonstrates that pain relief is not the sole reason for postoperative opioid use; opioids are also used to maintain functionality and to facilitate a return to daily life. Our findings highlight the need for patient-centered approaches, as well as education and guidance, when planning interventions aimed at preventing persistent opioid use.