Vanderbilt Summer Science Academy

A Randomized Controlled Trial to Reduce Excess Opioids After Cesarean Delivery

The number of drug overdose deaths involving opioids in the United States has quadrupled over the past 15 years.  The opioid epidemic is further driven by an increased number of prescription opioids dispensed from hospitals. 

Cesarean delivery is the most common surgical procedure performed in the United States. While opioids are the predominant analgesic used to treat pain after cesarean, there are no recommendations to guide opioid prescribing in this population.  A previous study examining post-discharge opioid use after cesarean delivery found that over 75% of women had unused opioids with an average of 10 unused tablets per person. However, a significant number reported using all prescribed opioids and having unmet pain needs.

The objective of this study is to reduce unused opioids after cesarean delivery by comparing a customized opioid prescription to a standard prescription.

Women undergoing a cesarean delivery at Vanderbilt Hospital were enrolled and randomized in a 1:1 ratio to a customized versus standard opioid prescription.  A survey was given one day after delivery asking about pain and medication use.  Customized prescriptions were made based off inpatient opioid use between 24 to 48 hours post-delivery. A 14-day follow-up call was completed to determine the amount of unused opioid pills and if their pain was effectively treated.

We hypothesize that customizing opioid prescriptions to an individual’s inpatient use will result in less unused opioids, therefore reducing the potential for opioid misuse and diversion.  By reducing excess opioids in the most common surgical procedure, we can combat opioid abuse.