• Posted July 3, 2024

Just a Few Surgeries Make Up Most Post-Op Opioid Prescriptions

Opioid addiction often starts with a prescription for post-surgery pain relief, and two new studies identify a handful of procedures that account for large shares of those prescriptions.

The findings were published recently in two major medical journals.

"Our findings suggest that surgical opioid prescribing is highly concentrated among a small group of procedures," said Dr. Kao-Ping Chua of the University of Michigan Opioid Research Institute, lead author of a study published in Pediatrics. "Efforts to ensure safe and appropriate surgical opioid prescribing should focus on these procedures."

With opioid addiction a growing problem in the United States, many surgeons encourage patients to rely on other pain-relievers such as non-steroidal anti-inflammatory drugs like aspirin and ibuprofen as soon as they are able.

For the study, researchers looked at surgeries between Dec. 1, 2020, and Nov. 30, 2021. They determined which procedures accounted for the highest shares of opioids and the size of prescriptions for each procedure. They said many patients were prescribed far more medication than they would typically need for a particular procedure.

The top three procedures for children aged 11 and younger accounted for 59% of opioids dispensed after surgery, the study found. Half were prescribed after removal of tonsils and adenoids; 5% after broken arms; and 4% after removal of deep implants. 

Among 12- to 21-year-olds, those procedures accounted for roughly a third of post-operative opioid prescriptions: 13% for tonsillectomies and adenoidectomies; 13% for knee surgery; and 8% for cesarean deliveries.

Among adults ages 18 to 44, C-sections were No. 1, accounting for 19% of post-surgery opioid prescriptions, followed by hysterectomies (7%) and knee surgeries (6%).

And among 45- to 64-year-olds, four of the top five procedures were orthopedic surgeries. All told, they accounted for 27% of postoperative opioid prescriptions.

"Our findings suggest there are important opportunities to reduce surgical opioids prescribing without compromising pain control," said Dominic Alessio Bilowus, lead author of a paper focused on adults published in JAMA Network Open. He is a medical student at Wayne State University.

Opioid addiction is a growing problem in the United States. More than 130 people a day die from opioid-related drug overdoses, according to the U.S. Health Resources and Services Administration.

More information

The Mayo Clinic has more about managing pain after surgery and the risks of opioid use.

SOURCE: University of Michigan, news release, June 28, 2024