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Postoperative opioid prescription fill rate 7 times higher in US, Canada vs. Sweden

The rate of postoperative opioid prescriptions filled was seven times higher in the United States and Canada than in Sweden, according to a study recently published in JAMA Network Open.

“Excessive postoperative opioid prescribing has been associated with increased risks of drug diversion, new long-term opioid use, and the development of opioid use disorder,” Karim S. Ladha, MD, MSc, assistant professor in the department of anesthesia at the University of Toronto, and colleagues wrote.

To evaluate postoperative opioid prescribing in the U.S., Canada and Sweden, researchers conducted a cohort study of patients with no prior opioid prescriptions who had low-risk surgical procedures performed in one of the three countries.

A total of 129,379 patients from the United States, 84,653 patients from Canada, and 9,802 patients from Sweden were included in the study.

In Sweden, only 11.1% of patients filled opioid prescriptions within 7 days, compared with 76.2% of patients in the U.S. and 78.9% of patients in Canada.

 

The rate of postoperative opioid prescriptions filled was seven times higher in the United States and Canada than in Sweden, according to a study recently published in JAMA Network Open.

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The mean morphine milligram equivalent dispensed within a week of discharge was highest in the U.S. (247 MME), followed by Sweden (197 MME) and Canada (169 MME).

Researchers found that codeine was more commonly dispensed in Canada (39.3%) and Sweden (15.7%) than in the U.S. (3.3%). Tramadol was dispensed more frequently among patients from Sweden (29%) and Canada (18.5%) than among U.S. patients (3.5%).

“These findings highlight opportunities to encourage judicious use of opioids in the perioperative period in both the U.S. and Canada,” Ladha and colleagues wrote. “Understanding the societal and cultural factors that influence these prescribing patterns could inform areas of further research and identify targets for future interventions.” – by Erin Michael

Disclosures: Ladha reported receiving support from Merit Awards from the department of anesthesia at the University of Toronto. Please see study for all other authors’ relevant financial disclosures.