Article Recommended by Dr. Don Stader: Opioid Prescribing by US Surgeons, 2016-2022

 A recent cross-sectional study published in JAMA demonstrates just how impactful the opioid stewardship movement of recent years has been on opioid prescribing rates. Using data from the IQVIA Longitudinal Prescription Database, researchers sought to quantify the amount of opioids surgeons were prescribing from Jan 2016 to Dec 2022. 

Key Takeaways:

• Over the interval in question, monthly surgical opioid dispensing rate per 100k (figure A), mean MME’s per prescription (figure B) and monthly total MME’s per 100k all decreased each year.

  • Monthly surgical opioid dispensing rate decreased from 661.2 to 426.0 prescriptions per 100 000 people (35.6%)

  • Monthly mean total MMEs per prescription decreased from 414.0 to 222.0 prescriptions (approximately 44 pills containing 5 mg hydrocodone)

  • Monthly total MMEs per 100 000 people decreased from 273 746 to 94 548 MMEs (65.5%).

• The only exception being in the first quarter of 2020 when surgery volumes plummeted due to the COVID-19 pandemic. In this period, prescription size increased while dispensing rates decreased.

• Of note, the mean size of opioid prescription from surgeons was 44 pills in Dec 2022, higher than what the Michigan Opioid Prescribing Engagement Network recommends. 

Conclusion:

• Opioid Stewardship initiatives have undoubtedly had an effect on the prescribing habits of surgeons, resulting in much less opioids in the community. Although this is a huge victory, more steps can be taken to use alternatives to opioids and reduce unnecessary opioid prescriptions.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2812627?resultClick=1