Haytham M.A. KaafaraniKelsey HanMohamad El MohebNapaporn KongkaewpaisanZhenyi JiaMajed W. El HechiSuzanne van WijckKerry BreenAhmed EidGabriel RodriguezManasnun KongwibulwutAsk T. NordestgaardJoseph V. SakranHiba EzzeddineBellal JosephMohammad HamidiCamilo OrtegaSonia Lopez FloresBernardo J. Gutierrez-SougarretHuanlong QinJun YangRenyuan GaoZhiguo WangZhiguang GaoSupparerk PrichayudhSaid DurmazGwendolyn van der WildenStephanie SantinMarcelo A.F. RibeiroNapakadol NoppakunsomboomRamzi AlamiLara El-JamalDana NaamaniGeorge VelmahosKeith D. LillemoeShanghai Oriental HospitalTongji UniversityAmerican University of BeirutHospital do Servidor Publico EstadualMassachusetts General HospitalChulalongkorn UniversityShanghai Jiao Tong UniversityKing Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn UniversityLeiden University Medical Center - LUMCChangzheng HospitalFaculty of Medicine, Siriraj Hospital, Mahidol UniversityThe University of ArizonaJohns Hopkins UniversityRede D'Or Hospitals NetworkHospital Departamental de VillavicencioHospital Ángeles Pedregal2020-12-282020-12-282020-12-01Annals of surgery. Vol.272, No.6 (2020), 879-886152811402-s2.0-85090787806https://repository.li.mahidol.ac.th/handle/20.500.14594/60546OBJECTIVE: The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world. SUMMARY OF BACKGROUND DATA: The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes to the opioid epidemic. METHODS: Patients ≥16 years old undergoing appendectomy, cholecystectomy, or inguinal hernia repair in 14 hospitals from 8 countries during a 6-month period were included. Medical records were systematically reviewed to identify: (1) preoperative, intraoperative, and postoperative characteristics, (2) opioid intake within 3 months preoperatively, (3) opioid prescription upon discharge, and (4) opioid refills within 3 months postoperatively. The median/range and mean/standard deviation of number of pills and OME were compared between the US and non-US patients. RESULTS: A total of 4690 patients were included. The mean age was 49 years, 47% were female, and 4% had opioid use history. Ninety-one percent of US patients were prescribed opioids, compared to 5% of non-US patients (P < 0.001). The median number of opioid pills and OME prescribed were 20 (0-135) and 150 (0-1680) mg for US versus 0 (0-50) and 0 (0-600) mg for non-US patients, respectively (both P < 0.001). The mean number of opioid pills and OME prescribed were 23.1 ± 13.9 in US and 183.5 ± 133.7 mg versus 0.8 ± 3.9 and 4.6 ± 27.7 mg in non-US patients, respectively (both P < 0.001). Opioid refill rates were 4.7% for US and 1.0% non-US patients (P < 0.001). CONCLUSIONS: US physicians prescribe alarmingly high amounts of opioid medications postoperatively. Further efforts should focus on limiting opioid prescribing and emphasize non-opioid alternatives in the US.Mahidol UniversityMedicineArticleSCOPUS10.1097/SLA.0000000000004225