Could New Surgical Recommendations Cut Opioid Use?

By Kelly Burch 12/29/17

A new study found that non-opioid pain relief including acetaminophen and ibuprofen could control 85% of post-surgery pain.

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doctor talking to patient about prescription pills

Many states have passed laws limiting prescription opioids to a one-week supply following surgery, but that still leaves a huge range of pills available, since a week’s supply can be as few as 20 or as many as 80 pills.

A new study published in the Journal of the American College of Surgeons aims to create specific guidelines for prescribing opioids after surgery, with the potential to cut opioid use by 40%. 

The study found that 85% of surgery patients were prescribed an opioid, but only 38% of opioids prescribed were taken, leaving many pills leftover that could be misused by the patient or family members. Moreover, researchers found that non-opioid pain relief including acetaminophen and ibuprofen could control 85% of post-surgery pain, according to The Union Leader

Dr. Richard Barth, Chief of Surgery at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire, and one of the study's authors, said the research found that in general, fewer pills were needed to effectively control pain after surgery. He said that by recognizing this, surgeons who are writing prescriptions can help keep pills off the street. 

“I know I prescribe opioids for patients that I operate on; I was just wondering if I could do that better and optimize that and help to diminish this epidemic,” Barth told The Union Leader. “The Surgeon General has said if doctors keep prescribing more pills than are actually needed, then this crisis is going to go on unabated.”

The study set specific guidelines with the goal of "relieving 85% of patients' pain." “If 1 to 3 opioid pills are taken the day before discharge, then a prescription for 15 opioid pills is given at discharge; and if 4 or more pills are taken the day before discharge, then a prescription for 30 opioid pills is given at discharge,” study authors wrote.

“If people use our guidelines, it will remarkably decrease the amount of opioids prescribed by about 40% compared to standard prescribing,” Barth said.

As a surgeon, Barth said that many of his colleagues want to make sure that people are comfortable following their operation. “Most doctors want to make sure their patients were pain-free and didn’t have to come back,” Barth said.

However, opioid use after surgery carries a risk of addiction, which increases for every additional day that someone takes the pills. In addition, unused pills can become a danger if they are not disposed of properly.

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

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