Postoperative opioid protocol: A 5-year resident-led effort to standardize prescribing patterns

•Variable surgeon prescribing preferences and low resident comfort level led to excess post-operative opioid prescriptions•A 5-year, ENT Department, resident led effort to standardize postoperative prescription practices at an academic hospital.•The Protocol resulted in a 66 % reduction in opioid prescriptions, equivalent to >97,000 doses of oxycodone.•There was a commensurate 68 % reduction in patient refills, suggesting continued, adequate pain control.•There was a 74 % reduction in cost of post-operative pain medications, equivalent to nearly $47,000.