Opioid consumption after lower limb amputation in Medicare beneficiaries.

The study used Medicare prescription fills, which are a proxy for opioid use and do not show whether the patient actually took the medication. The paper says patients were 65 years and older, but Table 1 lists age groups under 65, so the age range is unclear. Most patients were male and Medicare beneficiaries, so results may not apply to younger patients, other insurance, or patients who did not discharge home. The database did not show why each opioid prescription was written, so persistent opioid use may reflect other pain conditions rather than postamputation pain. The study did not measure clinically important details such as why the amputation was needed, and it did not test any rehabilitation treatment. Associations cannot show cause because many medications and patient factors were recorded together.

Do not read the associations as proof that opioids, gabapentinoids, or prescriptions for benzodiazepines, sedatives, hypnotics, and anxiolytics caused persistent opioid use. This study used prescription fills, did not know why each opioid was prescribed, and did not test any treatment.