{"doi":"10.31234/osf.io/pq7dh","title":"Do opioid analgesics improve subjective well-being? A prospective observational study of acute opioid effects before surgery","abstract":"Exposure to opioid analgesics due to surgery increases the risk of new persistent opioid use. A mechanistic hypothesis for opioids’ abuse liability rests on the belief that in addition to pain relief, acute opioid treatment improves mood, e.g. via euphoria and anxiety relief. However, opioids do not consistently improve mood in laboratory studies of healthy non-opioid users. Here, we determined how two commonly used opioid analgesics affected patients’ subjective well-being in standard clinical practice. Day surgery patients rated their mood before and after open-label infusion of remifentanil (N=159) or oxycodone (N=110) on the operating table before general anesthesia. One minute after drug injection, patients reported feeling intoxicated (>6/10 points). As hypothesized, anxiety was reduced after opioids; this anxiolytic effect was however modest (remifentanil Cohen’s d=0.21; oxycodone d=0.31). Unexpectedly, we found moderate to strong evidence against a concurrent improvement in positive affect (Bayes Factors >6.5). After remifentanil, ratings of ‘feeling good’ were even significantly reduced from pre-drug ratings (d=0.28). After oxycodone, only 1 in 3 participants felt better than pre-drug. Ordered logistic regressions revealed a link between prior drug exposure and opioid mood effects: while opioid-naïve patients were unlikely to feel better (21%) after opioids, the odds were >4 times higher given a history of prolonged opioid use (>2 weeks, adjusted OR=4.4). In sum, these ecologically valid data suggest that mood improvement by opioids in opioid-naïve patients is infrequent. Nevertheless, perioperative exposure could mechanistically increase risk of persistent use by elevating the likelihood of positive mood improvement during post-operative opioid treatment.","journal":"PsyArXiv (OSF Preprints)","year":2022,"id":301667,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9548,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":992767,"name":"Isabell M. Meier","orcid":"0000-0002-7606-1059","position":1,"is_corresponding":false},{"id":992768,"name":"Guro Engvig Løseth","orcid":"0000-0003-4178-3278","position":2,"is_corresponding":false},{"id":992769,"name":"Martin Trøstheim","orcid":"0000-0002-6021-6714","position":3,"is_corresponding":false},{"id":993114,"name":"Nikoline Ørstavik","orcid":null,"position":4,"is_corresponding":false},{"id":993115,"name":"Eira Nordeng Jensen","orcid":null,"position":5,"is_corresponding":false},{"id":403023,"name":"Eric L. Garland","orcid":"0000-0003-2891-857X","position":6,"is_corresponding":false},{"id":992770,"name":"Chantal Berna","orcid":"0000-0001-8258-7412","position":7,"is_corresponding":false},{"id":992771,"name":"Gernot Ernst","orcid":"0000-0001-5224-0338","position":8,"is_corresponding":false},{"id":625708,"name":"Siri Leknes","orcid":"0000-0002-6667-4601","position":9,"is_corresponding":false},{"id":992766,"name":"Marie Eikemo","orcid":"0000-0001-5103-919X","position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-19T00:32:02.193874Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}