Understanding post-operative opioid use across multiple surgical specialties.

Abstract

Background: The United States (US) is facing an opioid epidemic. Prescribed opioids are a contributor to this national issue. Strategies to reduce opioid prescriptions are a high priority. This study was designed to generate patient-level data on opioid use after surgery across different surgical specialties. We showed these data to surgeons and evaluated the impact it would have on their practice.

Methods: A cross-sectional survey-based study was performed in a teaching community hospital in the US. Adult patients who underwent an operation by a member of the Department of Surgery and the surgeons who performed these operations were surveyed. Patient-level data were obtained on opioid use after surgery. The number of opioid tablets taken and days on opioids were recorded. Patients were assessed for the frequency of recovery from surgery without opioids. Additionally, information on prescriptions filled and unused opioid disposal was collected. These data were presented to surgeons who responded on how having access to it may change their future prescribing habits.

Results: Opioid consumption after surgery was found to be far below expert panel guidelines across surgical specialties. Orthopedic surgery was found to be associated with significantly higher opioid use in the post-operative period. The small number of surgeons who responded showed that a large percentage planned to change opioid prescribing habits after gaining access to these data.

Conclusions: This project contributes to the growing body of literature showing lower than expected opioid usage for patients after surgery. Previous trends were mostly generated from large academic centers, and this community hospital data show consistent findings of patients being left with significant quantities of unused opioids routinely after surgery. It highlights the need for evidence-based prescribing recommendations as well as the need for better education and access to opioid disposal for patients.