Reducing Superfluous Opioid Prescribing Practices After Brain Surgery: It Is Time to Talk About Drugs

Area of Science:

• Neurosurgery
• Pain Management
• Public Health

Background:

• Opioid overprescribing is common after cranial surgery due to a lack of evidence on optimal quantities.
• Excessive opioid use contributes to abuse, chronic dependence, and diversion.

Purpose of the Study:

• To assess the effectiveness of a system-wide educational intervention aimed at reducing opioid prescribing after cranial surgery.
• To ensure adequate pain management is maintained during the reduction of opioid prescriptions.

Main Methods:

• A retrospective cohort study compared opioid prescribing patterns before and after a 2-month educational intervention for neurosurgical patients.
• The intervention involved didactic seminars for senior staff, residents, and advanced practice providers.
• Opioid prescribing and refill requests were analyzed for 203 patients undergoing craniotomy for tumor resection.

Main Results:

• Opioid prescriptions decreased by 52% post-intervention (32.1 MME/day to 15.4 MME/day).
• Opioid refill requests dropped by 56% (17% to 8%).
• No significant increase in outpatient pain scores was observed.

Conclusions:

• A targeted educational program effectively reduced opioid prescribing after intracranial surgery.
• This intervention improved prescribing practices, potentially reducing patient harm and addressing public health concerns.
• Simple, evidence-based educational strategies can significantly impact clinical decision-making in opioid management.