OBJECTIVES: This pilot study examined pain management for selected surgeries by analyzing the association between opioid related adverse drug events (ORADE) and length of stay (LOS), total hospitalization cost and 30-day all cause readmission. METHODS: The Premier Healthcare Database was queried to identify adult inpatients discharged between 2011 and 2014 who received postsurgical opioids following open colectomy, Hip Replacement or Knee Replacement defined by ICD-9 procedure code.  Comorbidities and adverse drug events were defined using ICD-9 diagnosis codes.  Descriptive statistics including the outcomes of LOS, total visit cost, and 30-day readmission were calculated. For comparing patients with and without ORADE, t-tests for continuous variables and chi-squared tests for categorical variables were used (alpha = 0.05).  Gamma regression was used to calculate adjusted estimates for LOS and total cost and Logistic regression was used to calculate the adjusted odds of having a 30-day readmission. RESULTS: There were 669,374 patients, average age of 65.5 (SD 11.4) with the majority female (59.4%), that met the study criteria. The percentage of patients with comorbidities ranged from 0.7 % with Regional Enteritis to over 80% with osteoarthritis with significant differences comparing the ORADE and no ORADE patients.  Overall, 10.1% of patients had an ORADE.  The unadjusted mean LOS (+3.9 days p<0.0001), total visit cost (+$6,892 p<0.0001), and readmissions (+5.9% p<0.0001) were higher for patients with ORADE compared to those without ORADE.  Adjusted analysis held similar LOS (5.4 days vs. 3.6 days, p<0.0001), total cost ($20,163 vs. $17,615, p<0.0001) and 30-day readmission (odds ratio 1.15, 95% CI 1.12-1.18) CONCLUSIONS: Occurrence of ORADE in the selected surgeries significantly increased the LOS, total cost and 30-day readmissions. In this study, higher dosages of opioids are associated with the incidence of ORADE; more research is needed to determine whether strategies to decrease opioid use improves outcomes and reduces ORADEs.