Opioid prescription size and persistent use significantly decreased.

Among 989,354 opioid-naïve patients, initial opioid prescription size dropped from 282 mg to 164 mg morphine equivalents, and new persistent opioid use declined from 2.7% in 2013 to 1.1% in 2021. These changes suggest effective opioid stewardship practices. Increases in prescription size correlated with higher persistent use, with every 30 mg increase linked to a 3.1% rise in new persistent opioid use. Other significant predictors included preoperative non-opioid prescriptions and specific surgical procedures.