National opioid prescription decline across outpatient specialty surgeries: a claims database study

J Am Acad Dermatol. 2025 Apr 14:S0190-9622(25)00610-3. doi: 10.1016/j.jaad.2025.04.019. Online ahead of print.

ABSTRACT

BACKGROUND: The Centers for Disease Control and Prevention (CDC) encourages physicians to limit unnecessary opioid prescriptions.

OBJECTIVE: The proportion of patients from 2009-2022 who filled an opioid prescription within 1 week after same-day, outpatient procedures.

METHODS: Patients aged 18 years and older from Optum Clinformatics Data Mart (CDM) who underwent one of the following: reduction mammoplasty (plastic surgery), Mohs micrographic surgery (dermatologic surgery), endoscopic sinus surgery (otorhinolaryngology), arthroscopic shoulder surgery (orthopaedic surgery), strabismus surgery (ophthalmology), and vasectomy (urology).

RESULTS: The rate of filled opioid prescriptions for all surgeries increased from 42.8% in 2009 (29854/69781) to a peak of 43.1% (26897/62348) in 2010. Opioid fill rates decreased annually thereafter to 15.9% in 2022 (9784/61420). Opioid fill rate average annual percent change was statistically significant across all surgeries (p<0.001). The annual percent change (APC) for opioid fill rates significantly declined from 2012 to 2017 (APC -5.4, p<0.001). The rate of decline more than doubled from 2017 to 2022 (APC -12.9, p<0.001).

LIMITATIONS: CDM is representative of the US population, however, it may not be generalizable to non-commercially insured patients.

CONCLUSION: There has been a decrease in opioid prescriptions after same-day outpatient procedures across multiple surgical subspecialties, demonstrating improved opioid stewardship.

PMID:40239813 | DOI:10.1016/j.jaad.2025.04.019