The U.S. and Canada are seven times more likely to prescribe opioids than Sweden

Patients in the United States and Canada are seven times as likely as those in Sweden to receive a prescription for opioid medications after surgery, according to a new multi-institutional study led by researchers from Penn Medicine. Though the United States and Canada had similar prescription rates, patients in the U.S. were prescribed a much higher dosage—as measured by the total morphine milligram equivalents (MME). The findings were published in JAMA Network Open.

shelf of prescription bottles, focused on one bottle of OxyContin.

To compare international opioid prescribing rates after surgery, researchers analyzed data on four frequently performed procedures: surgery to remove the appendix, surgery to remove the gallbladder, a minimally invasive procedure to treat a torn meniscus cartilage in the knee, and a procedure to remove a breast lump.

Within seven days of discharge, about 75% of the patients in the U.S. and Canada filled an opioid prescription, compared to just 11% of the patients in Sweden. By the one-month mark, nearly half of U.S. patients had received high-dose opioid prescriptions (i.e., prescriptions totaling more than 200 MME)—nearly double the rate in Canada (25%), and nine times higher than the rate in Sweden (5%).

“Our findings reveal stark differences in prescribing practices across the three countries and suggest real opportunities to encourage more judicious use of opioids before and after surgery for patients in the United States and Canada,” says the study’s corresponding author Mark D. Neuman, an associate professor of anesthesiology and critical care and Chair of the Penn Medicine Opioid Task Force. “While innovative strategies, like enhanced recovery protocols, have helped to reduce the number of prescribed opioids, it’s clear that we need to continue to identify ways to improve prescribing practices in the United States and Canada.”

Read more at Penn Medicine News.