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Michigan OPEN


OPEN examines data, clinical practices and strategies to support better pain management, opioid stewardship, policy, treatment and care.

Surgeon Experience and Opioid Prescribing

Santosa KB, Wang CS, Hu H, Brummett CM, Englesbe MJ, Waljee JF. Surgeon Experience and Opioid Prescribing. Am J Surg. 2020; 220(4): 823-827.
  • Among opioid na├»ve Medicare patients aged 65 and older who underwent major/minor surgery, 53.8% of patients filled an opioid prescription within seven days of discharge.
  • Opioid prescription size was largest for patients whose surgeons were early in practice (<7 years: 292 OMEs), with decreasing amounts of opioids filled among patients with surgeons who had been in practice longer (8-15 years: 279 OMEs; 16-25 years: 265 OMEs).

A Statewide Comparison of Opioid Prescribing in Teaching Versus Nonteaching Hospitals

Cron DC, Hwang C, Hu HM, et al. A statewide comparison of opioid prescribing in teaching versus nonteaching hospitals. Surgery. 2019;165(4):825-831. doi:10.1016/j.surg.2018.10.005
  • In Michigan, surgical patients discharged from teaching hospitals fill significantly larger opioid prescriptions and have higher rates of high-risk prescribing compared with patients discharged from nonteaching hospitals.
  • All hospitals, particularly teaching hospitals, should devote adequate resources to facilitating safe postoperative opioid prescribing.

Provider Characteristics Associated with Outpatient Opioid Prescribing After Surgery

Cron DC, Lee JS, Dupree JM, et al. Provider Characteristics Associated With Outpatient Opioid Prescribing After Surgery. Ann Surg. 2020;271(4):680-685. doi:10.1097/SLA.0000000000003013
  • Advanced practice providers account for 1-in-5 postoperative opioid prescriptions.
  • Postoperative opioid prescriptions written by advanced practice providers are 18% larger than those written by physicians.
  • All providers should be involved in postoperative care to understand prescribing practices and identify barriers to reducing prescribing.

Opioid Overdose-the Surgeon’s Role

Vu JV, Lin LA. Opioid Overdose-the Surgeon's Role. Ann Surg. 2018;268(1):32-34. doi:10.1097/SLA.0000000000002713
  • It is crucial for surgeons to perform a series of preoperative assessments (check for history of substance abuse, previous overdose, past opioid prescriptions, comorbid conditions, etc.) in order to identify patients with an increased risk of opioid overdose.
  • More surgeon involvement in research, evidence-based practice, and education will help to combat opioid misuse and overdose after surgery.