Opioid limits didn’t change surgery patients’ experience, study shows

A study* published by the Journal of the American Medical Association found that Blue Cross Blue Shield of Michigan’s five-day opioid prescribing limit for general surgeries didn’t negatively affect the pain of patients compared with those who had longer prescriptions.

By taking a close look at the number of days patients need to take opioids to control their pain after surgery, Blue Cross has reduced the likelihood of patients becoming addicted, Dr. James Grant, senior vice president and chief medical officer at Blue Cross, told AIS Health, a communications company owned by Managed Markets Insight and Technology, which supports the pipelines delivering treatments to patients.

“We want our members to have their pain controlled, but we've got so many other non-narcotic modalities now that we can employ that we've been able to really cut opioid prescribing rates, which greatly lowers the risk of opioid addiction for Michiganians,” Dr. Grant said.

The five-day supply limit took effect in 2018 and is more restrictive than the state of Michigan’s seven-day supply limit.

The JAMA study is the second in recent months from a prestigious medical journal to recognize that Blue Cross’ approach to limiting opioid prescriptions isn’t contributing to a patient’s pain level (see “Michigan outperforms national trends in reducing opioid prescribing after surgery” in the July-August 2023 issue of Hospital and Physician Update).

Both studies were confined to six common surgical procedures:

• Minimally invasive gallbladder removal
• Appendix removal
• Minor hernia repair
• Major hernia repair
• Removal of part of the colon (colectomy)
• Hysterectomy

The studies relied on data from the Michigan Surgical Quality Collaborative,* which is a Blue Cross-funded Collaborative Quality Initiative. The database doesn’t include more invasive procedures, including knee replacements and spine surgery, which would most likely require a higher dose of opioids for pain management.

MSQC is one of 21 CQIs that Blue Cross supports. For more information on CQIs, click here.

*Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.