WEDNESDAY, July 5, 2023 -- The perceived risk of opioid addiction affects patients' choice of pain medications after Mohs surgery, with patients favoring over-the-counter medications (OTCs) if the opioid addiction risk profile was high, according to a study published online July 5 in JAMA Dermatology.

Shannon T. Nugent, M.D., from the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia, and colleagues examined patient preferences for pain management with only OTCs or OTCs plus opioids among patients undergoing Mohs surgery in a prospective discrete choice experiment.

The researchers found that of the 295 respondents, 34 percent stated that they would never consider opioids for pain management, regardless of the level of pain experienced; 50 percent expressed concern regarding possible opioid addiction. Overall, 76 percent of respondents preferred only OTCs versus OTCs plus opioids for pain control across all scenarios. Given pain levels of 6.5 on a 10-point scale, half of the respondents expressed a preference for OTCs plus opioids when the theoretical risk of addiction was low (0 percent). At higher opioid addiction risk profiles (2, 6, and 12 percent), the preference for OTCs plus opioids and only OTCs was not equal; patients favored only OTCs despite experiencing high levels of pain in these scenarios.

"These findings may spur research investigating the risk of long-term opioid use after Mohs micrographic surgery and provide a framework for Mohs surgeons to engage in shared decision-making discussions with patients moving forward," the authors write.

One author disclosed ties to Regeneron.