Physician guidelines for standardized postoperative opioid prescription are associated with a decrease in morphine prescribing among emergency general surgery patients without an increase in requested or received refills. Elise A. Biesboer, MD, and colleagues designed a quasi-experimental study to evaluate opioid prescribing by emergency general surgery clinicians before and after the implementation of a standardized prescribing guideline. The primary outcome of the study was the proportion of patients receiving an opioid prescription more than or equal to 50 morphine milligram equivalents per day at hospital discharge. The researchers included 227 patients before the guideline and 226 patients after guideline implementation. Results showed a significant reduction in the amount of strong pain medication prescribed after surgery, from a median of 113 to 75 prescriptions. The proportion of patients receiving high-dose prescriptions decreased from 75% to 25%. Despite these results, there were no increases in patients requesting or receiving refills for their medication and guideline compliance ranged from 75% to 94% across different types of surgery. The findings highlight the potential efficacy of standardized prescribing guidelines in optimizing postoperative pain management while maintaining patient safety.