{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T00:07:54Z","timestamp":1793405274758,"version":"4.5.0"},"reference-count":54,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Opioid medications are commonly prescribed for the management of acute postoperative pain. In light of increasing awareness of the potential risks of opioid prescribing, data are needed to define the procedures and populations for which most opioid prescribing occurs.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To identify the surgical procedures accounting for the highest proportion of opioids dispensed to adults after surgery in the United States.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n \n This cross-sectional analysis of the 2020-2021 Merative MarketScan Commercial and Multi-State Databases, which capture medical and pharmacy claims for 23 million and 14 million annual privately insured patients and Medicaid beneficiaries, respectively, included surgical procedures for individuals aged 18 to 64 years with a discharge date between December 1, 2020, and November 30, 2021. Procedures were identified using a novel crosswalk between 3664\n Current Procedural Terminology<\/jats:italic>\n codes and 1082 procedure types. Data analysis was conducted from November to December 2023.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n The total amount of opioids dispensed within 3 days of discharge from surgery across all procedures in the sample, as measured in morphine milligram equivalents (MMEs), was calculated. The primary outcome was the proportion of total MMEs attributable to each procedure type, calculated separately among procedures for individuals aged 18 to 44 years and those aged 45 to 64 years.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 1\u202f040\u202f934 surgical procedures performed (mean [SD] age of patients, 45.5 [13.3] years; 663\u202f609 [63.7%] female patients), 457\u202f016 (43.9%) occurred among individuals aged 18 to 44 years and 583\u202f918 (56.1%) among individuals aged 45 to 64 years. Opioid prescriptions were dispensed for 503\u202f058 procedures (48.3%). Among individuals aged 18 to 44 years, cesarean delivery accounted for the highest proportion of total MMEs dispensed after surgery (19.4% [11\u202f418\u202f658 of 58\u202f825\u202f364 MMEs]). Among individuals aged 45 to 64 years, 4 of the top 5 procedures were common orthopedic procedures (eg, arthroplasty of knee, 9.7% of total MMEs [5\u202f885\u202f305 of 60\u202f591\u202f564 MMEs]; arthroscopy of knee, 6.5% [3\u202f912\u202f616 MMEs]).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cross-sectional study of the distribution of postoperative opioid prescribing in the United States, a small number of common procedures accounted for a large proportion of MMEs dispensed after surgery. These findings suggest that the optimal design and targeting of surgical opioid stewardship initiatives in adults undergoing surgery should focus on the procedures that account for the most opioid dispensed following surgery over the life span, such as childbirth and orthopedic procedures. Going forward, systems that provide periodic surveillance of opioid prescribing and associated harms can direct quality improvement initiatives to reduce opioid-related morbidity and mortality.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.17651","type":"journal-article","created":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T11:36:17Z","timestamp":1719401777000},"page":"e2417651","source":"Crossref","is-referenced-by-count":33,"title":["Epidemiology of Opioid Prescribing After Discharge From Surgical Procedures Among Adults"],"prefix":"10.1001","volume":"7","author":[{"given":"Dominic","family":"Alessio-Bilowus","sequence":"first","affiliation":[{"name":"Section of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor"},{"name":"Overdose Prevention Engagement Network, Ann Arbor, Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kao-Ping","family":"Chua","sequence":"additional","affiliation":[{"name":"Department of 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Accessed February 20, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK554974\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2820373\/alessiobilowus_2024_oi_240579_1718381666.0581.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,26]],"date-time":"2024-06-26T11:36:29Z","timestamp":1719401789000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2820373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,26]]},"references-count":54,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,3]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.17651","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,26]]}}}