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6% of patients discontinued systemic opioids completely. 11.0% of patients used 200 mg OME. Mean OME decreased by 94% following IDDS implant (p less then 0.0001) and all patients who continued to use systemic opioids required a lower OME compared to pre-implant. Conclusions In the largest cohort of patients with advanced cancer and refractory pain treated with IDDS, implantation was associated with a dramatic reduction in systemic opioid use 30 days postoperatively, with a large majority of patients discontinuing systemic opioids. Those