US Study Finds Opioid Prescribing at Discharge Varies by Surgical Specialty

Opioids are commonly prescribed for postoperative pain, but prescribing patterns differ across procedures. Researchers used the 2024 American College of Surgeons National Surgical Quality Improvement Program database to assess discharge opioid prescriptions and daily dose among adults undergoing selected procedures in the United States. The analysis included 757,548 procedures; outcomes were receipt of a prescription and prescribed daily dose in morphine milligram equivalents (MME).

Overall, 565,959 patients (74.7%) received an opioid prescription at discharge, and 4.1% received a refill. Median daily doses ranged from 30 to 45 MME across surgical specialties. Adjusted probabilities of receiving a prescription ranged from 54.1% in cardiac surgery and 60.0% in vascular surgery to 84.3% in orthopedics and 85.3% in thoracic surgery. Laparoscopic hernia repair, knee and hip arthroplasty, spine fusion, and laminectomy/corpectomy each had adjusted prescribing probabilities above 83%.

The findings provide contemporary descriptive benchmarks that may inform efforts to reduce variation in postoperative prescribing. The cross-sectional analysis describes prescribing, not whether prescriptions were needed or used, and cannot establish effects on pain, opioid-related harms, or patient outcomes. The data were drawn from a surgical database and covered selected procedures, so the estimates may not represent all US operations.