This study found a very large variability in the use of postoperative opioids in different countries. The study sample included 129,379 opioid-naïve patients in the US, 84,653 in Canada, and 9,802 in Sweden.
More than 70% of surgical patients in the US (76.2%) and Canada (78.6%) filled opioid prescriptions after four surgical procedures (ie, laparoscopic cholecystectomy, laparoscopic appendectomy, arthroscopic knee menisectomy, breast excision), compared with 11.1% in Sweden.
Of the three countries, the US had the highest average morphine milligram equivalent (MME) dose of opioid prescriptions for most surgical procedures at 247 MME, compared with 169 MME in Canada, and 197 MME in Sweden.
The results show that the US and Canada have a seven-fold higher rate of opioid prescriptions filled in the immediate postoperative period compared with Sweden. Understanding the societal and cultural factors that influence these prescribing patterns could inform areas of further research and identify targets for future interventions, the researchers note.