Post-Operative Opioid Prescription Rates Differ Depending on Patients' Opioid-Taking Histories, Research Finds

Patients who were already on high dose opioids prior to surgery were more likely to obtain larger prescription refills after surgery.

Matt MacKenzie

March 23, 2026

Key Highlights

Approximately 7.4% of surgical patients were on high-dose opioids, with 19.5% on low-dose, indicating widespread preoperative opioid use.
Initial post-surgery opioid consumption was similar regardless of preoperative use, but high-dose users were more likely to refill prescriptions after 90 days.
The study emphasizes the importance of perioperative strategies that consider preoperative opioid use to promote safe and effective pain management.
Structured transitions back to patients' usual prescribers are recommended to support opioid stewardship and reduce potential misuse.
Findings highlight the need for tailored approaches to manage opioid use in surgical patients with chronic opioid therapy.

A team at University of Michigan Medical School has identified a “lack of evidence around prescription practices for patients who come to surgery on high doses of opioids for chronic conditions.”

Roughly one in five patients “routinely use opioids or are on long term opioid therapy.” This research team investigated a cohort of 72,616 surgical patients; 7.4% were on high-dose opioids and 19.5% were on low-dose opioids. At first, consumption did not vary; the number of opioid pills consumed for surgery was “similar across all three groups [including those who were not taking opioids prior to surgery] in the first week following discharge.”

After 90 days, “patients who were already on high dose opioids were much more likely to obtain prescription refills on par with the amount of opioids they were taking before surgery.” These results highlight the need for “perioperative strategies that account for preoperative opioid use and for structured transitions back to patients’ usual prescribers to support safe, effective opioid stewardship.”