Lessons learned tackling high opioid prescribing.

Abstract

As a practice of 10 000 patients, we identified all patients who were prescribed opioid-based analgesia at daily doses greater than 120 mg. In total, 35 patients were identified and we have spent the last 12 months reducing these doses down to below 120 mg. So far, 29 of the patients have reduced below 120 mg daily morphine (one patient left the surgery, one died, and one was removed due to unacceptable behaviour unrelated to reducing their opioids). The remaining three patients are all expected to reduce below 120 mg in the next 3 months. Lessons we have learned from the project are as follows: As clinicians, we had limited awareness of the different potency of some opioids, specifically oxycodone and fentanyl. Very high daily morphine doses were found in these groups (highest doses were 480 mg daily morphine for oxycodone and 404 mg daily morphine for …