Agarwalla A, et al. - Patients undergoing total hip arthroplasty (THA) from 2007 through the first quarter of 2017 were reviewed from the PearlDiver database to ascertain the incidence and risk factors for prolonged opioid usage following THA due to hip fracture (Fx) or osteoarthritis (OA). A preoperative narcotic prescription was made for 1,794 OA patients (33.2%) and postoperative narcotic use was reported in 1,655 patients (30.6%), while preoperative narcotic prescription was reported for 418 Fx patients (23.2%) and postoperative narcotic use was reported in 499 patients (27.7%). Significant predictors of chronic postoperative opioid use were a diagnosis of femoral neck fracture and overall preoperative narcotic use. Additional consultation and more prudent follow-up with regards to pain management are recommended for patients with significant risk factors for opioid dependence.