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Invited Commentary
February 21, 2018

Opioid Stewardship and the Surgeon

Author Affiliations
  • 1Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
JAMA Surg. 2018;153(2):e174875. doi:10.1001/jamasurg.2017.4875

The opioid epidemic in the United States is a critical public health issue. There were 33 091 deaths from opioid overdoses in 2015, which represents a nearly 400% increase since 1999.1 The role of prescription painkillers in this epidemic cannot be ignored. More than half of these deaths in 2015 involved prescription opioids, and the total amount of oxycodone hydrochloride and hydrocodone bitartrate sold to retail pharmacies has increased by nearly 300% from 2000 to 2016.2 In this issue of JAMA Surgery, Chen and colleagues3 present a timely assessment of the association between inpatient opioid use and opioid prescriptions at hospital discharge in a cohort of patients undergoing surgery at 2 academic medical centers. They identified wide variations in prescribing patterns, and found that, strikingly, although one-third of patients did not receive opioids in the 24 hours prior to hospital discharge, 42.9% of these patients were prescribed opioids at hospital discharge.

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