PT - JOURNAL ARTICLE AU - Bleicher, Josh AU - Brooke, Benjamin Sands AU - Bayless, Kimberlee AU - Anderson, Zachary AU - Beckstrom, Julie AU - Zhang, Chong AU - Presson, Angela P AU - Huang, Lyen C AU - Buys, Michael Jacob TI - Postoperative opioid prescribing, use and pain trends following general surgery procedures: a retrospective cohort study among veterans comparing non-opioid versus chronic opioid users AID - 10.1136/rapm-2021-103382 DP - 2022 Aug 01 TA - Regional Anesthesia & Pain Medicine PG - 487--493 VI - 47 IP - 8 4099 - http://rapm.bmj.com/content/47/8/487.short 4100 - http://rapm.bmj.com/content/47/8/487.full SO - Reg Anesth Pain Med2022 Aug 01; 47 AB - Introduction Understanding postoperative opioid use patterns among different populations is key to developing opioid stewardship programs.Methods We performed a retrospective cohort study on opioid prescribing, use, and pain after general surgery procedures for patients cared for by a transitional pain service at a veterans administration hospital. Discharge opioid prescription quantity, 90-day opioid prescription, and patient reported outcome pain measures were compared between chronic opioid users and non-opioid users (NOU). Additionally, 90-day total opioid use was evaluated for NOU.Results Of 257 patients, 34 (13%) were on chronic opioid therapy, over 50% had a mental health disorder, and 29% had a history and/or presence of a substance use disorder. NOU were prescribed a median (IQR) of 10 (7, 12) tablets at discharge, while chronic opioid users were prescribed 6 (0, 12) tablets (p<0.001). 90-day opioid prescription (not including baseline opioid prescription for chronic users) was 10 (7, 15) and 6 (0, 12) tablets, respectively (p=0.001). There were no differences in changes in pain intensity or pain interference scores during recovery between groups. Median 90-day opioid use post discharge for NOU was 4 (0, 10) pills.Discussion Non-opioid and chronic opioid users required very few opioid pills following surgery, and patients on chronic opioid therapy quickly returned to their baseline opioid use after a small opioid prescription at discharge. There was no difference in pain recovery between groups. Opioid prescribing guidelines should include patients on chronic opioid therapy and could consider recommending a more conservative prescribing approach.Data are available upon reasonable request.