Recommendations for Prescribing
Pain Medication at Discharge after Elective Surgery
These recommendations apply to opioid-naïve adult patients undergoing an elective surgical procedure. They are intended for use by healthcare providers involved in the management and care of surgical patients.
Originally published as a Consensus Statement in the Canadian Journal of Pain in 2020, the recommendations have been updated in 2026 through a national modified Delphi consensus process involving clinicians from across Canada.
The recommendations aims to encourage healthcare providers to:
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Minimize the prescription of opioids and encourage the use of nonopioid therapies for postoperative pain to ensure that fewer opioid-containing tablets are available for diversion.
Educate patients and their families/caregivers on pain management options in relation to functional recovery.
A full peer-reviewed publication describing the update process is anticipated in 2027.
The 2020 Consensus Statement remains available here.
SafeOp - Updating the Recommendations
The University of Toronto Centre for the Study of Pain, with support from Health Canada's Substance Use and Addictions Program, is leading the SafeOp project to update the "Consensus Statement for the Prescription of Pain Medication at Discharge after Elective Adult Surgery."
The project’s overarching goal is to prevent harm in the post-discharge setting, both by ensuring effective pain management, and by minimizing opioid-related harms such as misuse and diversion.
To ensure the recommendations reflect the latest evidence and best practices in prescribing pain medication for opioid-naive adults undergoing elective surgery, the SafeOp project:
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Reviewed the most recent evidence and best practices through an expert-led national consensus process, resulting in updated recommendations.
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Is now working to disseminate these recommendations to healthcare providers who prescribe pain medication at discharge from hospital, including surgeons, anesthesiologists, family physicians, nurse practitioners, and trainees, and to share related resources with patients and their caregivers.
A peer-reviewed publication describing the update process is anticipated in 2027.
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