Small number of procedures account for large number of opioid prescriptions

A small number of surgical procedures, including orthopedic procedures and cesarean delivery, account for a large proportion of opioid prescriptions dispensed after surgery, according to a study published online June 26 in JAMA Network Open.

Dominic Alessio-Bilowus, from Michigan Medicine in Ann Arbor, and colleagues examined the surgical procedures accounting for the highest proportion of opioids dispensed to adults after surgery in the United States in a cross-sectional analysis of the 2020 to 2021 Merative MarketScan Commercial and Multi-State Databases. Data were included for 1,040,934 surgical procedures performed: 43.9 and 56.1 percent among individuals aged 18 to 44 and 45 to 64, respectively.

The researchers found that opioid prescriptions were dispensed for 48.3 percent of the procedures. Cesarean delivery accounted for the highest proportion of total morphine milligram equivalents (MMEs) dispensed after surgery among individuals aged 18 to 44 years (19.4 percent). Four of the top five procedures among individuals aged 45 to 64 years were common orthopedic procedures (e.g., arthroplasty of the knee, 9.7 percent; arthroscopy of the knee, 6.5 percent).

“Going forward, targeted opioid stewardship initiatives focused on these procedures may provide the greatest value in optimizing postoperative opioid prescribing,” the authors write.

One author disclosed ties to the biopharmaceutical industry.

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