“…That said, there is generally a lack of consistent guidelines for opioid prescribing post-surgery, particularly for opioidnaïve patients, with studies utilizing a variety of dosages (e.g., 50-2000 MME) or any dosage to examine the association between dose and later use [18,19,22,25,26]. Whereas 90 MME is considered high-dose prescribing, it is still lower than that examined in some studies, and our study detected a significant difference in the likelihood of a refill between ≤ 90 MME and >90 MME, demonstrating the need for guidelines for opioid-naïve patients [4,7,[18][19][20][21][22]. Additionally, there has been a focus in the literature on opioid prescriptions for chronic or pre-operative pain and the risk of continued use, while surgical patients receive the greatest amount of potent opioids [6,7,10,19,23].…”