(HealthDay News) — Patients in the United States and Canada receive prescription opioids after surgeries at a rate that is approximately 7 times higher than the rate in Sweden, according to a study published online in JAMA Network Open.

Karim S. Ladha, MD, of the University of Toronto, and colleagues studied 223,834 opioid-naive patients who underwent 1 of 4 low-risk surgeries (laparoscopic cholecystectomy, laparoscopic appendectomy, arthroscopic knee meniscectomy, or breast excision) between 2013 and 2016 in the United States (129,379 patients), Canada (84,653 patients), or Sweden (9802 patients). The authors examined the rate at which patients filled a prescription for an opioid medication within the first 7 days after discharge.

The researchers found that patients in the United States and Canada were more likely to fill a prescription for opioids and also received a greater quantity of medication. Approximately 76.2% of patients in the United States and 78.6% of patients in Canada filled a prescription for opioids within 7 days after their operation compared with 11.1% of patients in Sweden. Patients in the United States also received higher quantities of medication, with mean morphine milligram equivalents of 247 in the United States, 169 in Canada, and 197 in Sweden.

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“Our findings reveal stark differences in prescribing practices across the 3 countries and suggest real opportunities to encourage more judicious use of opioids before and after surgery for patients in the United States and Canada,” a coauthor said in a statement.

One author disclosed financial ties to pharmaceutical companies.


Ladha KS, Neuman MD, Broms G, et al. Opioid Prescribing After Surgery in the United States, Canada, and Sweden. JAMA Netw Open. 2019;2(9):e1910734. doi:10.1001/jamanetworkopen.2019.10734

Colvin LA. Opioid Prescribing After Surgery—Cause for Concern? JAMA Netw Open. 2019;2(9):e1910721. doi:10.1001/jamanetworkopen.2019.10721

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