Too Many Opioids After Cesarean Delivery

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Doctors may be overprescribing opioids to women who have had cesarean sections.

Researchers tracked prescriptions and pill use in 179 women discharged from an academic medical center after cesarean delivery. On average, they left the hospital with a prescription for the equivalent of 30 pills containing 5 milligrams of oxycodone or hydrocodone. Then, using interviews, the scientists tracked how much of the medicine they used during the two weeks after discharge. The study is in Obstetrics & Gynecology.

Those in the top quarter of opioid use after discharge had consumed more than twice as much of the medicine while they were hospitalized. They were also more likely to have smoked during pregnancy and to have public health insurance, but they did not differ from the others in education, body mass index, history of depression and other characteristics.

Certified nurse-midwives prescribed 50 percent less medicine over all than doctors. Most women used the pills for about eight days, and 75 percent had unused medicine at the end of the two weeks.

“About a quarter of the women used all their pills and still reported they had pain,” said the lead author, Dr. Sarah S. Osmundson, an assistant professor of obstetrics at Vanderbilt University, “so it’s not so simple as ‘just use less.’ We need to figure out how to individualize opioids, as opposed to giving all patients the same prescription.”