• Kalynne Harris, Scott Calder, Brooke Larsen, Keith Duffy, Glen Bowen, Payam Tristani-Firouzi, Michael Hadley, and Justin Endo.
• †Deceased; *Department of Dermatology, University of Utah, Salt Lake City, Utah; and ‡Department of Dermatology, University of Wisconsin, Madison, Wisconsin.
• Dermatol Surg. 2014 Aug 1;40(8):906-11.

BackgroundLittle is known about postoperative opioid prescribing patterns among dermatologic surgeons.ObjectiveTo better understand postoperative opioid prescribing patterns among dermatologic surgeons in the United States.Materials And MethodsTwo-part analysis consisting of a retrospective chart review of 233 dermatologic surgery patients at a single institution and an e-mail survey of American Society for Dermatologic Surgery (ASDS) members.Results(1) Retrospective review: 35% (82/233) of the patients received an opioid prescription. Larger defect size, repair of the defect, perioral and nasal site, and surgeon A or B performing surgery predicted opioid prescription. (2) E-mail survey: 556 ASDS members practicing within the United States responded. Sixty-four percent (357/556) reported prescribing opioids after ≤10% of cases. Surgeons younger than 55 years old, male surgeons, and surgeons in the southern and western United States were more likely to prescribe opioids after >10% of cases. Seventy-six percent (397/520) believed patients used ≤50% of the opioid pills prescribed.ConclusionThe retrospective review suggests that opioid prescribing is predicted by characteristics of the surgery (i.e., size, defect repair type, and anatomic location) and characteristics of the surgeon (i.e., age, sex, and practice location) with significant heterogeneity in prescribing habits. The national survey results raise the possibility that patients might not take all prescribed opioid pills after dermatologic surgery. Further investigation is warranted to determine how patients are actually using prescription pain pills to balance pain control with patient safety.

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