Publications (Old)

• After hydrocodone was changed from a schedule III to schedule II-controlled substance, the mean OMEs filled in the initial opioid prescription increased by approximately 35 OMEs, equivalent to 7 tablets of hydrocodone. 
• Following the schedule change, an increase in OMEs was observed among patients undergoing general surgery (mean difference of 28 OME), cardiac surgery (123.3 OME), orthopedic surgery (20.5 OME), spine surgery (66 OME), and vascular surgery (47 OME). 
• After scheduling change there was an increase in initial postoperative opioid amounts among opioid-naive patients (mean difference of 16.8 OMEs) and intermittent opioid users (60.3 OME), but not among long term opioid users.

Racial and Ethnic Differences in Elective vs. Emergency Surgery for Colorectal Cancer

Howard, R., Hendren, S., Patel, M., Gunaseelan, V., Wixson, M., Waljee, J., Englesbe, M., & Bicket, M. C. (2022). Racial and Ethnic Differences in Elective vs. Emergency Surgery for Colorectal Cancer. Annals of surgery, 10.1097/SLA.0000000000005667. Advance online publication. https://doi.org/10.1097/SLA.0000000000005667

Five Year Trends in Surgical Technique and Outcomes of Groin Hernia Repair in the United States

Ehlers, A. P., Lai, Y. L., Hu, H. M., Howard, R., Davidson, G. H., Waljee, J. F., Dimick, J. B., & Telem, D. A. (2022). Five year trends in surgical technique and outcomes of groin hernia repair in the United States. Surgical endoscopy, 10.1007/s00464-022-09586-z. Advance online publication. https://doi.org/10.1007/s00464-022-09586-z

Estimation of the Prevalence of Delayed Dispensing Among Opioid Prescriptions From US Surgeons and Dentists

Chua, K. P., Waljee, J. F., Smith, M. A., Bahl, S., Nalliah, R. P., & Brummett, C. M. (2022). Estimation of the Prevalence of Delayed Dispensing Among Opioid Prescriptions From US Surgeons and Dentists. JAMA network open, 5(5), e2214311. https://doi.org/10.1001/jamanetworkopen.2022.14311

The Opioid Epidemic

Upp, L. A., & Waljee, J. F. (2020). The Opioid Epidemic. Clinics in plastic surgery, 47(2), 181–190. https://doi.org/10.1016/j.cps.2019.12.005

Health Care Burden Associated with Outpatient Opioid Use Following Inpatient or Outpatient Surgery

Brummett, C. M., England, C., Evans-Shields, J., Kong, A. M., Lew, C. R., Henriques, C., Zimmerman, N. M., Pawasauskas, J., & Oderda, G. (2019). Health Care Burden Associated with Outpatient Opioid Use Following Inpatient or Outpatient Surgery. Journal of managed care & specialty pharmacy, 25(9), 973–983. https://doi.org/10.18553/jmcp.2019.19055

Disappointing Early Results from Opioid Prescribing Limits for Acute Pain

Chua, K. P., Kimmel, L., & Brummett, C. M. (2020). Disappointing Early Results From Opioid Prescribing Limits for Acute Pain. JAMA surgery, 155(5), 375–376. https://doi.org/10.1001/jamasurg.2019.5891

Limiting Opioid Prescribing-Reply

Chua, K. P., Brummett, C. M., & Waljee, J. F. (2019). Limiting Opioid Prescribing-Reply. JAMA, 322(2), 171–172. https://doi.org/10.1001/jama.2019.5864

• In Michigan, new persistent opioid use rate decreased from 3.29% to 2.51% following the release of prescribing guidelines, which was an additional 0.53% decrease compared to patients outside of Michigan.   
• Mean opioid prescription quantity for patients in Michigan decreased from 199.5 oral morphine equivalents (OMEs) to 88.6 OMEs after prescribing guidelines were released, which was an additional 55.7 OMEs decrease compared to patients outside of Michigan.

• The use of procedure-specific prescribing guidelines reduced statewide postoperative opioid prescribing and consumption by 50%.
• Saw zero change in patient reported satisfaction and pain scores

• Mean prescription size decreased by 8 pills after the guidelines were released and opioid consumption decreased by 3 pills
• Reduced prescription size and opioid use had no impact on patient satisfaction or pain scores

• Five procedures accounted for 95.2% of dental opioid prescriptions, and tooth extraction accounted for almost two-thirds of total prescriptions; 
• Tooth extraction accounted for ⅘ of prescriptions for adolescents and young adults and ⅗ of prescriptions for adults aged 26 through 64 years. 
• In 2018, 45.3% of tooth extractions resulted in 1 or more initial prescriptions

• No significant association between opioid prescription size and satisfaction 
• 83% of patients receiving the smallest opioid prescription (25 mg OME) were satisfied compared to 85% of patients receiving the largest opioid prescription size (750 mg OME) 

• A discharge opioid was prescribed to 22% of 675 children younger than 18 years 
  • Median 10 doses (25th to 75th percentile, 6-15) 
• Circumcision, elbow fracture, and orchiopexy had the highest opioid use; yet only 1 in 3 patients used an opioid, typically for 3 days or less.
• Overall, pain control was reported as good among 82% of children with or without a discharge opioid prescription.

• Patients use only 27% of opioids prescribed to them 
• Patients use an additional 5 pills for every 10 extra pills prescribed to them 
• The quantity of opioid prescribed is associated with higher patient-reported opioid consumption
• Greater association between prescription size and consumption than reported pain levels and consumption

• The proportion of initial prescriptions for surgery, emergency, and dental care increased by nearly 16% from 2010 to 2016.
• Dental care prescribing saw the greatest growth, with a 68% increase, while surgical patients received the highest proportion of potent opioids (90.2%).