Surgery and the Opioid Epidemic
What are the issues surrounding use of opioids after surgery? Are there any alternatives?
Check out The Lancet Podcast, "Postoperative pain management and opioids." (2) - (11m)
Can technology reduce the need for postoperative opioids?
Watch Dr. Jolene Singh's TEDx Talk, "Robotic Surgery and the Opioid Crisis." (3) -(9m)
What are the risks of prescribing large doses of opioids, and then tapering too quickly?
Check out Bioethicist, Travis Rieder's TEDx Talk, "The agony of opioid withdrawal-- and what doctors should tell patients about it." (4) - (14m)
Can telemedicine ensure greater post-operative outcomes in remote areas and across the globe?
Check out Dr. Shimul Shah's Behind the Knife interview, "Annals of Surgery Journal Club #12: Remote Monitoring." (5) - (32m)
Wouldn't it be dangerous to prescribe smaller doses of opioids after surgery?
Watch this Mayo Clinic video, "Mayo finds majority of opioid prescriptions unused after surgery" (5) - (1m)
How can we use education to stop the opioid crisis?
What are the stats surrounding opioids and surgery? How could we prescribe better after specific procedures?
If I am interested in this topic, where can I learn more?
Check out our Substance Use and Harm Reduction Module.
This article highlights a new approach by Blue Cross Blue Shield of Michigan to increase insurance reimbursements for surgeons who prescribe fewer opioids for patients after surgery.
This piece examines how the cost of limiting opioid prescriptions may also entail short-term consequences, including increased usage and mortality among people turning to heroin or fentanyl. The article derives data from a simulation study recently reported in the AJPH. An interesting read with great academic references!
Dive into this Vox piece, "Solving America's painkiller paradox." (11)
This article proposes four ways that clinicians can manage patient pain and still address the opioid epidemic in America.
This paper studied home opioid use among 333 surgical inpatients following discharge following various procedures. It found that 38% of prescribed opioid pills were taken. It concluded that opioid use the day before discharge was the best indicator of post-discharge use.
Resources from the Opioid Prescribing Engaging Network
· Homepage
· Patient and Community Education
· Pain Control Optimization Pathway
Sources
1. Scully et al. JAMA Surgery. (2017, Sept). Retrieved on Nov. 01, 2019 from: https://www.eurekalert.org/pub_releases/2017-09/bawh-doo092517.php
2. Myles P. Postoperative pain management and opioids. The Lancet Podcast. (2019, April 12). Retrieved on Nov. 03, 2019 from: https://www.stitcher.com/podcast/listen-to-the-lancet/e/59996838
3. Singh J. Robotic Surgery and the Opioid Crisis. (2019, Jan. 15). Retrieved on Nov. 07, 2019 from: https://www.youtube.com/watch?v=jipNhcJETYs
4. Rieder T. The agony of opioid withdrawal -- and what doctors should tell patients about it. (2017, October). Retrieved on Nov. 12 2019 from: https://www.ted.com/talks/travis_rieder_the_agony_of_opioid_withdrawal_and_what_doctors_should_tell_patients_about_it/transcript?language=en
5. Mayo Clinic. Mayo finds majority of opioid prescriptions are unused after surgery. (2018, May 17). Retreived on Nov. 07, 2019 from: https://www.youtube.com/watch?v=HeB9xx8Qa9k
6. Greenfieldboyce N. How To Teach Future Doctors About Pain In the Midst of an Opioid Crisis. (2019, Sept. 11). Retrieved on NOv. 07, 2019 from: https://www.npr.org/sections/health-shots/2019/09/11/756090847/how-to-teach-future-doctors-about-pain-in-the-midst-of-the-opioid-crisis
7. Englesbe M. Hot Topics in Surgery: Opioid Epidemic with Dr. Englesbe. (2019, Sept. 09). Retrieved on Nov. 03, 2019 from: https://behindtheknife.libsyn.com/hot-topics-in-surgery-opioid-epidemic-with-dr-englesbe
8. Scully et al. JAMA Surgery. (2017, Sept). Retrieved on Nov. 01, 2019 from: https://www.eurekalert.org/pub_releases/2017-09/bawh-doo092517.php
9. Erb R. Michigan surgeons offered more money to limit opioids for pain. Bridge: Michigan Health Watch. (2019, Oct. 15). Retrieved on Nov. 12, 2019 from: https://www.bridgemi.com/michigan-health-watch/michigan-surgeons-offered-more-money-limit-opioids-pain
10. Frakt A. The Opioid Dilemma: Saving Lives in the Long Run Can Take Lives in the Short Run. NY Times: The Upshot. (2019, March 4). Retrieved on Nov. 12, 2019 from: https://www.nytimes.com/2019/03/04/upshot/opioid-overdose-crisis-deaths.html
11. Lopez G. Solving America's painkiller paradox. Vox. (2018, Sept 06). Retrieved on Nov. 12, 2019 from: https://www.vox.com/science-and-health/2018/9/25/17327976/opioid-epidemic-painkiller-prescriptions
12. Hill MV, Stucke RS, Billmeier SE, Kelly JL, Barth RJ, Jr. Guideline for Discharge Opioid Prescriptions after Inpatient General Surgical Procedures. J Am Coll Surg; 226(6):996-1003. (2018, June).