There is growing concern about the over-prescription of opioids and the risks of long-term use. This study examined the relationship between initial need (pre-operative, post-operative, and discharge pain) and dosage of opioids in the first prescription after surgery with continued opioid use through opioid refills over 12 months, while considering patient-level characteristics. A total of 9262 opioid-naïve patients underwent elective surgery, 7219 of whom were prescribed opioids following surgery. The results showed that 17% of patients received at least one opioid refill within one year post-surgery. Higher initial opioid doses, measured in morphine milligram equivalent (MME), were associated with a greater likelihood of continued use. Patients receiving a dose greater than 90 MME were 1.57 times more likely to receive a refill compared to those receiving less than 90 MME (95% confidence interval: 1.30–1.90, p < 0.001). Additionally, patients who experienced pain before or after surgery were more likely to receive opioid refills. Those experiencing moderate or severe pain were 1.66 times more likely to receive a refill (95% confidence interval: 1.45–1.91, p < 0.001). The findings highlight the need to consider surgery-related factors when prescribing opioids and the importance of developing strategies to balance the optimization of pain management with the risk of opioid-related harms.

College students are a key population for opioid use, misuse, and subsequent exposure to overdose events. However, their knowledge and attitudes in respons

Introduction/problem Anxiety disorders are increasingly prevalent in sub-Saharan Africa (SSA). Limited data exist on factors contributing to anxiety, particularly among final year junior high school (JHS) students in Ghana preparing for the Basic Education Certificate Exam (BECE). Purpose This study aimed to investigate the factors influencing anxiety levels among final year JHS students in Ghana, focusing on hunger, parental support, sleep duration, co-occurring mental health concerns, gender, and other variables. Methods A sample of 394 final year JHS students in the Greater Accra Region of Ghana was surveyed using established measures for anxiety, sleep duration, parental support, hunger, substance use, and mental health concerns. Logistic regression analyses were conducted to explore the relationships between these variables and anxiety levels among students. Key findings The study revealed a high prevalence of anxiety among final year JHS students, with 71.4% exhibiting symptoms above the chronic anxiety cut-off point. Significant factors associated with anxiety included hunger, living with a single parent, and co-occurring mental health concerns. Age, gender, access to school counseling, school type, and substance use showed no significant associations with anxiety. Conclusions/implications The findings underscore the need for a comprehensive approach to addressing anxiety among final year JHS students, considering socio-economic factors, family dynamics, and mental health support. Stakeholders can use these insights to develop targeted interventions that promote mental well-being and academic success. Recommendations Enhancing access to mental health services, addressing socio-economic disparities, providing support for students from single-parent households, and integrating mental health education into school curricula are recommended.