Reducing Overprescription Practices for Opioid Use Post Anterior Cervical Surgery: The Impact of a Standardized Prescription Protocol.

Purpose: This study aimed to evaluate the impact of implementing a standardized opioid prescription protocol on prescription practices post-elective ACS surgery at a large academic institute.

Methods: A prospective cohort study with a retrospective control group was conducted following institutional review board approval. A standardized protocol was created and implemented which specified opioid prescriptions post-surgery. Data on opioid doses, total and daily Morphine Milligram Equivalents requirements, and the need for refills were collected and compared between both cohorts.

Results: The study included 83 patients in the post-protocol cohort compared with 315 age- and sex-matched patients in the pre-protocol cohort. The postprotocol cohort received markedly lower daily and total doses at discharge compared with the preprotocol group (P < 0.01). No increase was observed in prescription refills before the initial follow-up in the postprotocol cohort (P = 0.35). At 12 weeks postsurgery, fewer patients in the postprotocol group remained on opioids compared with the preprotocol group (P = 0.14).

Conclusion: Standardizing opioid prescriptions post-ACS surgery effectively reduces opioid doses prescribed without increasing refill rates. The findings support the efficacy of procedure-specific opioid prescription guidelines in reducing unnecessary opioid use and associated health and economic burdens.