Does Opioid Use Increase Depression Risk After HNC Surgery?

Background: Head and neck cancer (HNC) is associated with high rates of depression and prolonged opioid use, yet the relationship between postoperative opioid duration and new-onset depression in this population is unclear. Objective: To determine whether long-term opioid therapy (LTOT) is associated with depression following HNC surgery. Design: Retrospective cohort study. Methods: Opioid-naïve patients undergoing HNC surgery from 2007 to 2020 were identified using the national Veterans Health Administration administrative claims data. Postoperative opioid duration was categorized as 1 to 30 days, 31 to 90 days, or >90 days. New-onset depression within 24 months was the primary outcome. Results: 9148 patients were identified, and 24.3% received LTOT >90 days. New-onset depression rates per 1000 person-years were 46.8, 70.2, and 88.4 for the 3 duration groups, respectively. LTOT >90 days was associated with a 20% increased risk of depression compared to 1 to 30 days of use. LTOT more...