OPEN was founded in an effort to develop a preventive approach to the opioid epidemic by tailoring post-operative and acute care opioid prescribing. Our research has allowed us to create evidence-based prescribing guidelines based on the specific needs of each procedure. Since we’ve established these guidelines, opioid prescribing after surgery has declined by 50%. Our prescribing recommendations reference levels of evidence that were used to draw conclusions about opioid prescribing, so providers can make educated determinations about prescribing and care.
medical centers from 9/2014 to 3/2016 involving 720 women
undergoing cesarean delivery in the US.
Prospective data collection is ongoing for future revisions.Download PDF
Excessive prescribing of opioids after surgery places patients at risk of becoming new persistent users, a significant surgical complication.
Among opioid-naïve patients undergoing common surgical procedures, 6-10% continue filling opioid prescriptions 3-6 months after surgery.1,2 72% of opioids prescribed by surgeons go unused by patients.3
These procedure-specific prescribing recommendations were developed by Michigan OPEN to curb this over-prescribing of post-operative opioids. These recommendations, for patients with no preoperative opioid use, were informed by patient-reported data from our Collaborative Quality Initiative (CQI) partners, published studies, and expert opinion. For patients taking opioids preoperatively, prescribers are encouraged to use their best judgment.
As part of post-operative pain care, Michigan OPEN strongly advocates patient counseling prior to surgery, and the use of over-the-counter medications, when indicated.
These recommendations will be revised as new data becomes available. Subscribe to be notified by email when the recommendations are updated.
- Hill M, McMahon ML, Stucke RS, Barth RJ Jr. Wide variation and excessive dosage of opioid prescriptions for common general surgical procedures. Ann Surg. 2017;265(4):709-714.
- Bicket MC, Long JJ, Pronovost PJ, Alexander GC, Wu CL. Prescription opioid analgesics commonly unused after surgery: A systematic review. JAMA Surg. 2017;152(11):1066-1071.
- Howard R, Waljee J, Brummett C, Englesbe M, Lee J. Reduction in opioid prescribing through evidence-based prescribing guidelines. JAMA Surg. 2018;153(3):285-287.