As many as 300 million surgical procedures are performed annually, making surgical therapy, and related perioperative management, a clear contributor to public and population health. Concurrently, management of the opioid epidemic has emerged as a top public health priority, especially in the United States and Canada, where per capita prescription opioid use substantially exceeds the global average. While any direct link between perioperative opioid prescribing and population-level opioid misuse is complex, as opioids are routinely prescribed for postoperative pain management, anesthesiologists can have a role to play in opioid stewardship. As previously discussed in detail in the journal, the relationship between opioid prescribing practices and public health implications of the opioid epidemic exists within a multifaceted ecosystem. Ultimately, the interplay between provider behaviors (driving opioid supply), patient behaviors (driving demand), and the disposal rate of unused opioids impacts the overall pool of opioids in our communities. Shrinking the size...

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