Michigan Reduces Opioids After Surgery, Patients Fare Fine

The state of Michigan implemented opioid prescribing guidelines that resulted in people receiving fewer painkillers after surgery—but patients taking fewer pills did not experience more pain after procedures, according to a new study. 

The study, published in The New England Journal of Medicine, looked at information on patient satisfaction and outcomes in the seven months following the release of new opioid prescription guidelines in Michigan. The study examined results for nearly 12,000 patients, and found that the average number of pills patients were given following a surgery was reduced from 26 to 18. 

Controlling The Numbers

Despite the drastic reduction, patients reported “no clinically important changes in pain scores,” the study authors found. 

Study author Dr. Joceline Vu, a surgical resident at the University of Michigan, said that controlling the number of opioids people are given after a surgery can help reduce their risk for long-term use, and can help avoid introducing people to opioids. 

“For healthy people, surgery may be the first time they are exposed to opioids," she told ABC News. 

On average, Michigan physicians prescribed eight fewer opioids per patient after the guidelines were released. Patients took, on average, three fewer pain pills. The percentage of prescriptions that were for fewer pills increased from 20% to 59% during the seven months of the study. 

Dr. Joshua Sharfstein, who has studied the opioid epidemic as a professor at Johns Hopkins Bloomberg School of Public Health, said that the study shows that changing recommendations can have a real impact on doctors’ habits. 

"The results here are promising," he said. "Most [physicians] prescribe by routine, and changing those routines is hard. This shows that some changes are possible. It is important that this study be read, and people realize that changes are possible." 

Before the statewide guidelines were issued by the Michigan Surgical Quality Collaborative, there was no standard that doctors could turn to for guidance on how many opioids to prescribe. Vu explained that doctors always wanted to be sure patients had enough pain pills, so that patients would report that they were satisfied with their surgical experience. Having lower patient satisfaction could affect ratings for doctors and hospitals, she noted. 

However, the study found that patients did not experience increased pain levels when they were given fewer opioids. This shows that reducing the number of opioids prescribed is an effective way to mitigate the risks of opioids, without compromising patient comfort, the researchers say.