This analysis aims to evaluate nationwide trends in opioid prescribing patterns among sinus surgeons performing functional endoscopic sinus surgery and maxillary sinus balloon dilation, specifically examining factors associated with variations.

High-volume sinus surgeons were identified through the Centers for Medicare and Medicaid Services database and cross-referenced against Medicare Part D beneficiaries’ prescriptions. 

This cohort of 570 surgeons wrote 21,042 opioid prescriptions in 2015, with 80.3% and 54.7% writing >10 and >25 prescriptions, respectively. Surgeons writing many prescriptions wrote lengthier courses throughout all three years. Female otolaryngologists wrote lengthier prescriptions. Early career otolaryngologists offered fewer prescriptions than those who had a greater experience. Moreover, 73.6% of fellowship-trained otolaryngologists offered >10 prescriptions versus 82.7% of non-fellowship-trained otolaryngologists. Practitioners in the South, on average, prescribed the greatest amount of opioids.

Most sinus surgeons prescribe ≥25 opioid prescriptions annually, with otolaryngologists writing a more significant amount of medications and writing lengthier courses. As the mean opioid prescription length is 5.4 days, recent legislation limiting opioid prescriptions to 5 days may only have a modest impact on preventing the diversion of perioperative opioid prescriptions.