Do no harm: Surgeons should be leaders in opioid stewardship.

Drug overdose has killed tens of thousands of people in Canada. Surgery and postoperative opioid prescriptions introduce narcotics to opioid-naive patients, with risk as high as 13% for prolonged opioid use long after surgical recovery. Surgeons in North America prescribe opioids to more patients, and in much higher doses, to manage postoperative pain than surgeons in other countries for similar procedures. Yet, most postoperatively prescribed opioids often go unused by patients in North America. With 90% of opioids not taken as prescribed, this excess supply stocks the community for nonmedical opioid use. With opioid overdoses posing a public health crisis, we call on surgeons to be leaders in responsible opioid prescribing to reduce adverse effects of opioid use while maintaining adequate postoperative pain control.