America's struggle with the growing opioid epidemic has swept national headlines, with new reports estimating that 78 people die every day from overuse of opioids in the U.S.1
Unfortunately, research also shows that surgery has become an inadvertent gateway to opioid abuse, and can put patients at serious risk for addiction and dependence. In fact, a recent survey found that one-in-10 patients prescribed an opioid following surgery report becoming addicted to or dependent on the drug.2 With 70 million surgical patients in the U.S. receiving an opioid annually, these findings suggest that as many as 7 million patients could develop an opioid addiction or dependency after surgery this year.
To reduce this risk while effectively managing patients' pain, it's critical that hospital representatives – from the C-Suite to pharmacy to clinicians and nurses – implement a
team-based approach. A key component to accomplishing this strategy is increased communication between patients and their entire medical teams, including anesthesiologists, who can convey the value of reducing opioid exposure through enhanced recovery pathways that incorporate non-opioid pain control options.
Banishing the Burden on Surgeons
Coordinated communication among the health care team can alleviate the burden put on surgeons, as 91 percent feel pressure to prescribe more opioids than patients actually need.3 In fact, providers wrote nearly a quarter of a billion opioid prescriptions in 2013 – which is enough for every American adult to have their own bottle of pills.4
This issue of high-prescribing allows opioids to be easily shared, as more than 65 percent of people misusing painkillers are getting them from family and friends.5 While prescribing guidelines are an important step in addressing this issue, the best way for hospitals to take immediate action is to implement strategies that minimize preventable opioid exposure for patients.
For the safety of the patient, health care professionals need to work together to carefully assess a patient's risk for drug abuse. This can be as simple as having a detailed discussion about available pain management options and their associated risks and benefits, or as sophisticated as utilizing genetic testing during pre-surgical consult visits that can determine if a patient has a potential predisposition to opioid addiction. Both of these options empower patients to become their own advocates during discussions about postsurgical pain management, which includes asking questions and voicing their personal preferences related to what types of medications they'd like to avoid if possible. That's why it's important to alert patients and their caregivers to helpful resources, such as www.PlanAgainstPain.com, which has a customizable discussion guide to facilitate this important surgeon-patient discussion.
Communication Fosters Collaboration
The healthcare field needs to continue to raise awareness of the opioid problem, and provide sensible solutions including non-opioid options for pain management after surgery. While reversing the opioid epidemic is no easy feat, it is one we can certainly accomplish by working together. We must improve our dialogue with patients, as the onus is on the medical team to convey the risks associated by prescribing opioid painkillers – especially with nearly 90 percent of patients being concerned about side effects, addiction, or dependence.6
It is our job as medical professionals to not only provide quality care but to educate patients about their options, as many are unaware that they have choices to manage their postsurgical pain, including non-opioids. Besides revising internal policies regarding opioid use, hospitals must also strengthen their external partnerships with other organizations such as law enforcement, primary care practices and drug rehab facilities to create comprehensive solutions that can have a positive impact on our patients and our communities.
Ultimately, it will take a coordinated team effort to stop people from developing opioid addictions and dependencies, and hospitals and doctors must be up for the challenge.
Success in Working Together
Although surgery has become an unintentional gateway to the opioid epidemic, it is the responsibility of the team of healthcare professionals involved with providing patient care to help them make the best decisions to effectively manage their pain and have a successful recovery. Encouraging discussions between patients and healthcare professionals is a cornerstone of providing quality care and a critical component to combatting the opioid epidemic.
It is our job to help educate patients on the options available to them to manage postsurgical pain. By doing so we will empower our patients to seek alternatives, including non-opioids, and potentially mitigate the societal burden of opioid use. The war against opioid abuse and misuse must be waged on many fronts, and reducing or even eliminating opioid exposure in the hospital setting is a battle that can be won.
We have the tools necessary to make this change today. And it's something we can do by working together. Our patients deserve it.
1 https://www.cdc.gov/drugoverdose/epidemic/
2 Choices Matter Survey
3 Choices Matter Survey
4 IMS Health, National Prescription Audit (NPATM). Cited in internal document: Preliminary Update on Opioid Pain Reliever (OPR) Prescription Rates Nationally and by State: 2010-2013.
5 http://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs2014/NSDUH-DetTabs2014.pdf
6 Choices Matter Survey
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