From 2011 to 2020, there was a decrease in the proportion of patients obtaining an opioid prescription after Mohs micrographic surgery, according to a study published online Sept. 22 in JAMA Dermatology.

Surya A. Veerabagu, from the Tulane University School of Medicine in New Orleans, and colleagues conducted a cross-sectional study to characterize the frequency and changes over time (2009 to 2020) of opioid prescriptions following Mohs micrographic surgery. Data were included for 358,012 patients aged 18 years or older with Mohs micrographic surgery insurance claims.

The researchers found that from 2009 to 2011, there was an increase in the proportion of patients obtaining an opioid prescription after Mohs micrographic surgery (34.6 to 39.6 percent). Thereafter, there was a decrease in the proportion each year, reaching a low of 11.7 percent in 2020 (absolute decrease from 2011 to 2020, 27.9 percent). The four most commonly prescribed opioids were hydrocodone, codeine, oxycodone, and tramadol. Hydrocodone was obtained less by 2020 (absolute decrease from 2011 to 2020, 21.7 percent), and tramadol was obtained more (absolute increase from 2009 to 2020, 26.3 percent).

"Dermatologists should continue to conservatively prescribe opioids when necessary, using clinician judgment in each individualized situation and using over-the-counter and alternative medications as first-line analgesics whenever possible," the authors write.

Two authors disclosed financial ties to pharmaceutical companies.

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