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Published on: June 10, 2013
Changes in Opioid Prescription Patterns Following Implementation of the Controlled Substance Utilization Review and
Amy Steele1, Claire E Perrin2, Daniel R Massillon2
1Rady Children's Hospital, San Diego, California, USA.
Orthopaedic Journal of Sports Medicine
|July 11, 2026
Summary
Opioid prescriptions decreased significantly for pediatric arthroscopy patients after CURES implementation. While pain-related calls increased, additional prescriptions remained stable, indicating effective pain management with reduced opioids.
Area of Science:
- Pediatric Orthopedic Surgery
- Pain Management
- Public Health Policy
Background:
- Pediatric drug overdose deaths now exceed cancer deaths, highlighting the opioid epidemic's impact.
- The Controlled Substance Utilization Review and Evaluation System (CURES) was mandated to monitor opioid prescriptions.
- The effect of CURES on pediatric arthroscopic surgery pain management remains unassessed.
Purpose of the Study:
- To evaluate the impact of the CURES database implementation on opioid prescribing habits.
- To assess changes in postoperative pain management and prescription needs in pediatric patients undergoing arthroscopy post-CURES.
Main Methods:
- A cohort study compared pediatric and adolescent patients (ages 10-19) undergoing arthroscopic knee/shoulder procedures before (pre-CURES) and after (post-CURES) CURES implementation.
- Data included demographics, surgical details, and postoperative outcomes, focusing on pain-related triage calls and additional prescription needs.
- The study reviewed 244 patients pre-CURES and 224 patients post-CURES.
Main Results:
- The post-CURES cohort received significantly fewer total morphine milligram equivalents (MMEs) prescribed (89.4 ± 8.3 vs 444.3 ± 66.0; P < .001).
- Patients in the post-CURES group were more likely to contact triage nurses about pain (13% vs 7%; P = .03).
- There was no significant difference in the need for additional pain prescriptions between the cohorts (4% vs 4%; P ≥ .99).
Conclusions:
- Reduced opioid prescribing post-CURES did not lead to increased needs for additional pain prescriptions in pediatric arthroscopy patients.
- Increased triage calls post-CURES were managed effectively through education and reassurance, suggesting successful opioid-sparing pain management.
- While effective, postoperative care for adolescents undergoing arthroscopy could be further optimized to manage pain communication.
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