Introduction: Opioid misuse is costly in terms of morbidity, mortality, and humanitarian and economic burden. One risk factor related to opioid misuse and dependence is prescription following surgical procedures, and an estimated 12.5% of individuals who are prescribed opioids will misuse them. Materials and Methods: Active-Duty Soldiers undergoing third molar extraction (n = 45) were recruited at Womack Army Medical Center and provided access to the CPMRx mobile application to track their postoperative pain and use of prescribed pain medication (Percocet), as well as electronic monitoring pill bottles to provide timestamps for all instances of opioid use. Linear regression analyses modeled predictors of opioid use and misuse, including individual factors (e.g., smoking status) and clinical factors (e.g., time in surgery, ketamine use). Results: People who smoke used two times as many opioids following surgery as people who do not currently smoke. Soldiers with more than a high school education used less than half as those with only a high school education. Overall opioid use patterns showed that 45% of patients used 10 or fewer, and more than half used 12 or fewer. About a quarter of patients used all 21 pills. Bivariate results revealed associations between smoking status and education with opioid use. Smoking status was also related to postoperative pain, but only from Day 4 and later. Overall, the model predicting total opioid use was significant and accounted for 82% of the variance in opioids used. In addition to pain on Postoperative Day 4, education, smoking status, and age emerged as significant predictors. Conclusions: Feedback from the CPM clinical decision support tools prompted a reduction in the standard prescription from 25 to 16 pills. Clinicians were able to reduce overprescription by more than 10,000 opioids annually for a single surgery type, preventing excess medication from possible diversion or misuse in the Ft. Bragg community.
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