Approximately 4.2% of opioid-naïve ICU survivors develop new persistent opioid use within six months post-discharge.
Early opioid prescription within 30 days of hospital discharge is the strongest predictor of persistence (OR ~20).
Risk profiles differ by opioid potency: potent opioid use is mainly driven by cancer diagnoses, while less-potent opioid use aligns with demographic and socioeconomic factors.
Findings underscore the need for early opioid tapering strategies, multimodal analgesia, and tailored stewardship programs for ICU survivors.
