Wide Variation in Opioid Prescribing for Emergency Surgery Patients

Opioid prescribing in emergency general surgery varies significantly across hospitals, with discrepancies of 1.5 to 3.7 times in morphine equivalents. While most discharges follow elective guidelines (75%-96%), compliance drops sharply for colectomy, with only 4% adherence compared to 25% for appendectomy. Increased comorbidity and ASA classification correlate with non-guideline prescriptions, highlighting an urgent need for improved opioid stewardship tailored to the emergency context.