Background: Standardized prescribing models can reduce discharge opioid prescription and excess pill volumes, mitigating potential opioid dependence and diversion after abdominal operations. This study’s objective was to determine which of 2 validated discharge prescribing models resulted in fewer opioids prescribed and consumed after major abdominal surgery. Methods: This was a pragmatic single-center, phase II randomized clinical trial comparing 2 discharge opioid prescribing models: linear 5x