Inappropriate opioid prescription after surgery

Area of Science:

• Public Health
• Pain Management
• Pharmacology

Background:

• Global prescription opioid analgesic use more than doubled from 2001 to 2013.
• Opioid misuse epidemics are prevalent in countries like the USA, Canada, and Australia.
• Excessive post-surgical opioid prescribing is a significant public health issue and a potential driver of opioid misuse.

Purpose of the Study:

• To review the evolution of prescription opioid use for post-surgical pain in the USA, Canada, and other nations.
• To summarize evidence on the extent of post-surgical opioid overprescribing.
• To explore the association between overprescribing and subsequent opioid misuse, diversion, and opioid use disorder.

Main Methods:

• Review of existing literature on prescription opioid use for post-surgical pain.
• Synthesis of evidence on overprescribing patterns and their consequences.
• Discussion of patient, physician, and system-level factors influencing prescribing.
• Summary of current clinical and policy interventions.

Main Results:

• Significant increase in prescription opioid analgesic use globally.
• Evidence suggests a link between post-surgical overprescribing and increased risk of opioid misuse and disorder.
• Identified patient, physician, and system-level predictors contribute to excessive prescribing.
• Various clinical and policy efforts are underway to curb overprescribing while managing pain.

Conclusions:

• Post-surgical opioid overprescribing is a critical factor in the ongoing opioid crisis.
• Understanding predictors is crucial for developing targeted interventions.
• Balancing effective pain control with reduced opioid reliance is essential for public health.