Opioid Prescription Stable Among Sleep Surgeons, While Opioid Costs Trend Downward

by Linda Kossoff •

CLINICAL QUESTION

What can be learned from examining recent trends in opioid prescription among sleep surgeons in the U.S.?

BOTTOM LINE

Opioid prescription patterns among sleep surgeons in the U.S. remained stable from 2013 to 2021; surgeons with longer tenures exhibited higher rates of opioid prescribing during this time.

BACKGROUND: The opioid epidemic is a serious health issue in the U.S. Studies show that otolaryngology–head and neck surgeons often overprescribe opioids, partly because certain sleep surgery procedures are especially painful. Obstructive sleep apnea itself is a predictor of increased opioid use. Current practice guidelines prioritize non-opioid analgesia as first-line therapy.

STUDY DESIGN: Retrospective study

SETTING: Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco

SYNOPSIS: Using the Centers for Medicare and Medicaid Services database, researchers analyzed data from 82 otolaryngology–head and neck sleep surgeons (95.3% male) across the U.S. from 2013 to 2021. Metrics included the number of opioid beneficiaries and claims, opioid cost, and opioid day supply per beneficiary. Results showed no significant changes in the number of opioid claims per provider (mean 26.6) or opioid beneficiaries per provider (mean 20.6), nor was there a decrease in opioid day supply per beneficiary over the period. Surgeons who graduated residency before 2000 prescribed significantly more opioids compared to those graduating after 2000, with higher opioid day supply per beneficiary (13.34 versus 7.42), higher opioid beneficiaries per provider (21.62 versus 19.36), and higher opioid claims per provider (30.30 versus 21.78). A statistically significant decrease in opioid costs per beneficiary from 2013 to 2021 indicated an overall trend of declining costs. The authors state that these findings underscore the need to implement interventions such as improving education about post-operative pain and increasing the use of post-operative multi-modal analgesia after sleep surgery. The study’s limited dataset precluded the inclusion of data regarding providers’ practice composition and surgical volume.

CITATION: Saroya J, et al. Opioid prescription trends among sleep surgeons in the United States. Laryngoscope. 2024;134(11):4810-4817. doi: 10.1002/lary.31543. -4572. doi: 10.1002/lary.31574.