Shorter duration opioid prescriptions plus education could be better for patients after surgery

A small study could have big insights for opioid use after surgery. Greater opioid quantity for postsurgery patients has been associated with the development of addiction, noted authors of a study published in JAMA on June 25. Their study looked at whether reducing the number of opioid tablets prescribed after anterior cruciate ligament (ACL) knee surgery at a single academic ambulatory surgery center would reduce postoperative use, and if preoperative opioid-use education could reduce it even more.

A total of 264 patients were divided into three groups: 109 were prescribed 50 opioid tablets after surgery, 78 patients were prescribed 30 tablets and received education before surgery on appropriate opioid use and alternative pain control strategies, and 77 patients received 30 tablets and no education. 

According to patient responses received by survey 3 weeks after surgery, the research team found that patients who were prescribed 50 tablets consumed more and for more days than those given 30 tablets and no education who consumed less and for fewer days. Patients who received 30 tablets and preoperative education used fewer tablets and for fewer days than patients who received 30 tablets but no education.

There were several limitations to the study, according to researchers. Mainly, only one surgery center was involved, and the small patient group surveyed was young and not randomized.

In their conclusion, authors wrote: “In this study, half of prescribed opioids were consumed in each group, suggesting that prescribing even less might further reduce opioid use. Further investigation should evaluate whether similar opioid stewardship and education protocols would be successful in other patient populations.”