Opioid rates for knee surgery both high and varied

Examining insurance data, Penn researchers found that 36% of patients received an opioid prescription that was stronger than the CDC-recommended dose.

A new study published in BMJ Open found that opioid prescription rates for outpatient knee surgery vary widely across the country, but the strength of the average prescription in the United States is at a level that has been linked to an increased risk of overdose death.

Map of the US., states in red have above average opioid prescription rates states in blue are below, states in grey are average
Image: Penn Medicine News

While the nationwide rate at which patients—who had not already been taking opioids—received an opioid prescription after an arthroscopic knee surgery was found to be more than 70% across the United States between 2015 and 2019. The variation at the state level was stark, bottoming out at 40% in South Dakota and reaching 85% in Nebraska, the study shows. The strength of the typical prescription, though, was revealed to be high, equal to 50 milligrams of morphine per day, the level that the Centers for Disease Control and Prevention has identified as being the threshold for increased risk of opioid overdose death.

“We found massive levels of variation in the proportion of patients who are prescribed opioids between states, even after adjusting for nuances of the procedure and differences in patient characteristics,” says the study’s senior author, M. Kit Delgado, an assistant professor of emergency medicine and epidemiology in the Perelman School of Medicine. “We’ve also seen that the average number of pills prescribed was extremely high for outpatient procedures of this type, particularly for patients who had not been taking opioids prior to surgery.”

This story is by Frank Otto. Read more at Penn Medicine News.