Excess Opioid Medication and Variation in Prescribing Patterns Following Common Breast Plastic Surgeries.

Excess opioid prescribing has societal impacts including addiction, dependence, and misuse. This study aims to investigate prescribing patterns and self-reported patient experiences with opioid use, pain control, and disposal of unused medication following common breast surgeries. A total of 46 patients undergoing 5 breast procedures were identified during a predefined 14-week period. All procedures were carried out at a single tertiary care hospital by 9 plastic surgeons. Provincial narcotic monitoring program provided linked prescription information for identified patients. All patients were invited to participate in a telephone interview regarding postoperative opioid use. A total of 41.6% of patients received and filled an opioid prescription following a breast procedure. Hydromorphone was the most commonly prescribed narcotic. The average number of opioid tablets dispensed following breast procedures was 31.9. Four percent of breast patients required an opioid refill. A total of 75% of breast patients used at least 1 over-the-counter analgesic, most commonly acetaminophen alone. Average self-reported pain score and total pain period were not significantly different between those using opioids and those not. A total of 6.7% and 23.1% of patients report returning excess narcotics to a pharmacy, while the majority report still having or self-disposing of excess tablets. Opioids are prescribed in excess for the breast procedures we analyzed. The majority of unused opioids were noted to still be at home or disposed of inappropriately. This suggests a role for reviewing opioid-prescribing patterns for common plastic surgery procedures to reduce the burden of the ongoing opioid epidemic.