Opioid Prescription Size Strongest Predictor of Number of Pills Consumed

Clinicians commonly overprescribe opioids — and the larger the opioid prescription, the more pills a patient uses — a JAMA Surgery study suggests.

Using a Michigan surgery database, researchers studied 2400 adults who received opioid prescriptions after 12 common surgical procedures in 2017. At 30 days after surgery, patients reported how many opioid pills they had taken; they also reported their level of postoperative pain.

For each procedure, the median size of the opioid prescription exceeded the amount of opioids consumed (overall, 30 vs. 9 hydrocodone/acetaminophen 5/325 mg tablets). The median number of leftover pills per patient was 19.

Prescription size most strongly predicted the number of pills consumed: Patients took roughly 5 more pills for every additional 10 pills prescribed. Higher pain scores were associated with more opioid use, but the association wasn’t as strong as that for prescription size.

The researchers write, “Recognizing overprescribing and accurately identifying patient consumption … is the first step in improving prescribing practices.”