Owodunni OP, Zaman MH, Ighani M, et al. - In view of the observed poor postoperative outcomes among opioid-tolerant patients, researchers examined 646 opioid-tolerant patients undergoing abdominal surgery on an enhanced recovery pathway for pathway compliance and its impact on postoperative outcomes. Overall, 114 (18%) patients were opioid-tolerant and 532 (82%) were not opioid-tolerant. As per the adjusted analysis, a 26% reduction in length of stay and over a 90% reduction in major complications were evident, in addition to the mitigation of the effect on readmissions, in independent correlation with high compliance with the enhanced recovery pathway standards. In this challenging patient cohort, they recommend establishing strategies to improve compliance in order to decrease the negative impact of opioid tolerance.