Context:In the United States, the postoperative opioid prescriptions have been implicated in the so called "opioid epidemic". In Europe the extent of overprescribing or misuse of opioids are unsure. Objectives: To describe the proportion of persistent postoperative opioid use of adults (>18 Years) in European countries. Design: Systematic review of the published data. Data sources: We searched the electronic literature databases MEDLINE (Ovid), Embase (Ovid), PubMed/MEDLINE and Scopus. Eligibility criteria: Studies describing opioid use of adult patients (>18 years) at least 3 months after surgery.Results: 1307 studies were found, and 12 studies were included in the review. The rate of opioid users after 3 to 6 months was extracted from the studies and categorised into type of the surgery. Nine studies investigated the opioid use after total hip or total knee arthroplasties (THA and TKA) and reported opioid user rates between 7.9% and 41% after three months. In all included studies a proportion between 2.0% and 41.0% of patients were opioid users three months after surgery. The level of evidence varied from high to very low. Conclusion:To give statements about the persistent opioid use about specific countries or surgery types is not possible. Because of the observed ranges, we can neither confirm nor rule out a possible public health problem linked to the persistent use of opioids in Europe.