How much opioid pain medication do you need if you’ve had an operation or an injury? It might surprise you to hear that we don’t really know. There are lots of stories of people getting far more pain medication prescribed than they actually take — in fact, that’s one reason that the main source of opioids taken without a prescription is from friends and relatives with leftover prescription opioids.

We’re learning more about the right way to prescribe opioids every day, but to date the best paper about it is probably this one. In this paper, researchers asked a wide range of expert stakeholders — people who prescribe opioids, take care of surgical patients, and patients themselves — how many opioids should be prescribed for a wide range of surgical procedures. Maybe the biggest takeaway: for each of the 20 procedures, from open heart surgery to hernia repair, the minimum recommended number of opioids was ZERO, meaning the group thought none of the operations required opioid pain medication. The maximum suggested number varied but was never more than 20. Now, this is just one paper and it doesn’t cover every operation, but it’s a place to start in a conversation with your doctor about how many opioid tablets you really need.

Our partner, the Surgical Collaborative of Wisconsin, has also put together a pocket guide for common surgical procedures, with recommendations about opioid prescribing for some common operations. You can find that here.

And for children, there are some special rules. For example no child under 12 and no child under 18 and having tonsil or adenoid surgery should take the opioids codeine or tramadol. Here’s a video that explains why.

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