Plastic Surgeons Get Tips On How To Reduce Opioid Addiction Risks

By Britni de la Cretaz 10/10/17

One of the suggestions offered is for plastic surgeons to refer patients with a known history of addiction to a specialist prior to their procedure.

Surgeon performing cosmetic surgery on nose in hospital operating room.

A new paper aimed at plastic surgeons is providing guidelines for the profession on how to manage the risk of opioid addiction in their patients.

The paper, “Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period,” urges surgeons to understand that the medications they prescribe patients following surgery could put them at risk for developing an opioid use disorder. 

The paper appears in the October issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS), and was written by Daniel Demsey, MD, of University of British Columbia, Vancouver, and his colleagues. The ASPS is the largest organization of board-certified plastic surgeons in the world, representing more than 94% of board-certified plastic surgeons in the United States. 

"The scale of the opioid addiction epidemic is difficult to exaggerate," the paper reads, referring to the staggering number of people struggling with the drug in the U.S. "Surgeon opioid prescribing practices contribute to the opioid addiction crisis,” said Demsey, but "improvements in prescribing practices can improve patient safety."

According to the paper, plastic surgeons providing post-surgery drugs contribute to the ongoing opioid crisis by exposing people to drugs they could potentially misuse, as well as adding to the number of prescription opioids on the streets because less than 10% of people properly dispose of their unused medication—and over 92% of people don’t finish their scripts.

According to the CDC, nearly half of all opioid-related overdose deaths involve a prescription opioid, and deaths from opioids have quadrupled since 1999. Not only that, but sales of prescription opioids in the U.S. nearly quadrupled during that time period as well, though there has not been an overall change in the amount of pain Americans report.

However, a new study from the Annals of Internal Medicine's September 2017 issue indicates that the majority of opioid prescriptions are being filled by a small number of users, and cautioned that blanket legislation regarding opioid prescriptions could actually harm large numbers of people who need the drugs for pain management, post-surgery or otherwise.

Demsey's paper suggests methods for plastic surgeons to reduce risk when prescribing opioids for their patients.

These include referring patients with a known history of addiction to a specialist prior to their procedure; developing a weaning and drug disposal plan with patients; referring them to another provider for monitoring post-surgery; prescribing non-opioid pain relief medications; and educating patients about the dangers of opioid misuse and addiction.

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Britni de la Cretaz is a freelance writer, baseball enthusiast, and recovered alcoholic living in Boston. Follow her on Twitter at @britnidlc.