BACKGROUND CONTEXT As the opioid crisis has gained national attention, there has been an increasing effort to decrease opioid usage. Simultaneously, patient satisfaction is a crucial metric in the American health care system, and has been closely linked to effective pain management in surgical patients. PURPOSE Examine rates of pain medication prescription and concurrent patient satisfaction in spine surgery patients. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE A total of 1,729 patients undergoing any spine surgery. OUTCOME MEASURES Rates of non-opioid pain medication prescriptions during hospitalization as part of a multimodal analgesia regimen, morphine milligram equivalents (MME) of opioids used during hospitalization, Press Ganey Satisfaction Survey data. METHODS Patients ≥18yo undergoing spine surgery between 6/25/2017-6/30/2018 at a single institution by spine surgeons performing ≥20 surgeries/quarter and who had medication data during hospitalization available included. Additional data collected included physician and procedure type. All data analyzed by quarter. Chi-squared test to compare percentages and ANOVA to compare means across quarters. Multivariate regression used to compare procedure-specific trends, controlling for age, revision and level of pain. Significance set at p RESULTS A total of 1,759 patients were included, 427 in Quarter 1 (Q1), 439 in Q2, 453 in Q3 and 440 in Q4. Mean total MME per patient hospitalization was 574.46, no significant difference between quarters (p=0.116). Mean MME/day per patient decreased between quarters (p=0.048), with highest mean 91.84 in Q2 and lowest 77.50 in Q4. From Q1 to Q4, three physicians had decreased mean MME/day (75.47→50.92, p=0.023; 115.70→46.05, p=0.013; 92.89→69.53, p=0.42, respectively) and two physicians had decreased total MME (815.88→243.15, p=0.004; 706.79→451.72, p=0.014, respectively). MME/day decreased (74.78→52.37, p=0.046) for discectomy cases. Controlling for age, revision and level of pain, total MME decreased for discectomies (p=0.006). Among all procedures, acetaminophen, NSAID and steroid prescription rates increased (9.13%→17.05%, p=0.001; 6.32%→9.77%, p=0.048; 9.13%→17.05%, p=0.001, respectively). This was also the case in fusion patients specifically (9.09%→17.99%, p=0.002; 2.77%→5.76%, p=0.024; 9.09%→17.99%, p=0.002, respectively). NSAID prescription in laminectomy patients also increased (3.23%→4.89%, p=0.041). Concurrently, benzodiazepine and GABA analog prescriptions decreased among all procedures (19.20%→10.68%, p CONCLUSIONS Over the studied time period, opioid use decreased and nonopioid prescriptions increased during hospitalization, while satisfaction scores remained unchanged. These findings indicate an increasing effort in reducing opioid use amongst providers, and suggest the ability to do so without impacting overall satisfaction rates. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.