Opioids and Pain Management

This collection highlights contemporary challenges and innovations in surgical opioid stewardship and pain management, bringing together clinical trials, epidemiologic analyses, and health systems research that examine prescribing patterns, risk factors for persistent opioid use, and disparity across patient populations and care settings. The included studies explore strategies to reduce opioid exposure, while also addressing special populations, including patients on chronic opioids and those with complex pain syndromes. Collectively, these articles underscore the variability in prescribing practices, the global and socioeconomic dimensions of postoperative pain management, and the ongoing need for evidence-based, scalable approaches to optimize analgesia while minimizing opioid-related harm.

 Scroll to the CME Articles section for opportunities to earn AMA PRA Category 1 Credits™ related to this collection. 

April 2025

• Surgical opioid stewardship: from the epidemic through the pandemic and beyond

January 2025

• Epidemiology and outcomes associated with new persistent opioid use after transabdominal operation

September 2024

• Drivers of variation in opioid prescribing after common surgical procedures in a large multihospital healthcare system

Episode 45: Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial

In this episode, Thomas K Varghese, Jr, MD, FACS, is joined by Serena Lofftus, MD, and James Wu, MD, FACS, from UCLA. They discuss Drs Lofftus and Wu’s recent article, “Patient-Based Decision Making for Opioid Prescriptions After Ambulatory Breast Operation: A Randomized Clinical Trial,” which evaluated whether incorporating patient choice into postoperative prescribing decisions could reduce opioid prescribing and consumption after ambulatory breast operation without negatively affecting pain control or quality of life.

Episode 39: Postoperative Pain Management in the US vs Low- and Middle-Income Countries by US Surgeons

In this episode, Tom Varghese, MD, FACS, is joined by Ziad Sifri, MD, FACS, from Rutgers New Jersey Medical School, and Matthew Linz, MD, from Rutgers Robert Wood Johnson Medical School. They discuss Drs Sifri and Linz’s recent article, “Postoperative Pain Management in the US vs Low- and Middle-Income Countries by US Surgeons,” in which they found that surgeons in the US prescribe significantly more opioids after inguinal hernia repair compared with when they operate on short-term surgical trips to low- and middle-income countries, despite continued efforts to reduce opioid overprescription in the US.