The opioid epidemic in acute care surgery—characteristics of overprescribing following laparoscopic cholecystectomy

AbstractBackgroundPostoperative prescribing following acute care surgery must be optimized to limit excess opioids in circulation as misuse and diversion are frequently preceded by a prescription for acute pain. This study aimed to identify patient characteristics associated with higher opioid prescribing following laparoscopic cholecystectomy (LC).MethodsAmong patients age ≥18 years who underwent LC at a single institution 2014-2016, opioids prescribed at discharge were converted to oral morphine equivalents (OME) and compared to developing state guidelines (max 200 OME). Preoperative opioid use was defined as any opioid prescription 1-3 months before LC or a prescription unrelated to gallbladder disease 200 OME. Top quartile prescriptions (≥300 OME) were associated with gallstone pancreatitis diagnosis, younger age, higher pain scores, and longer length of stay (all p200 OME. Top quartile prescriptions (≥300 OME) were associated with gallstone pancreatitis diagnosis, younger age, higher pain scores, and longer length of stay (all p

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