Surgeons Are Still Prescribing Too Many Opioids

By Kelly Burch 06/26/19

Though opioid prescriptions have declined, surgeons are still prescribing more than the recommended number of pills.

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Surgeons are still prescribing far too many opioids to their patients following surgical procedures, increasing their risk of long-term opioid use or addiction. 

According to a recent analysis by Kaiser Health News and Johns Hopkins, surgeons still prescribe many times the recommended amount of pain medications. By analyzing Medicare data, the researchers found that some patients who undergo coronary bypass and knee surgeries took home more than 100 pain pills for the first week following their operations. Thirty pills would be the maximum amount recommended by current standards, researchers noted. 

Andrew Kolodny, director of the advocacy group Physicians for Responsible Opioid Prescribing, said, “Prescribers should have known better.” 

The researchers looked at data from 2011 to 2016. Even though opioid prescriptions started to decline during that time, the number of pills being prescribed was well above the recommended safe levels. Dr. Chad Brummett, associate professor at the University of Michigan, said that even if the prescription amounts have continued to fall since 2016 they are likely still too high. 

“When prescribing may have been five to 20 times too high, even a reduction that is quite meaningful still likely reflects overprescribing,” he said. 

Members of the medical community pointed out that surgeons were taught for years to mitigate pain by using opioids, but now they are being asked to drastically change the way they manage patients’ pain. Dr. David Hasleton, senior medical director in Utah said that it can be difficult to talk to doctors about their prescribing habits. 

“Globally, we were overprescribing by 50%,” he said Dr. David Hasleton, senior medical director. “If you go to a prescriber to say, ‘You are overprescribing,’ it never goes well. A common reaction is, ‘Your data is wrong’ or ‘My patients are different than his.’”

In fact, that’s exactly what happened when Kaiser reached out to the top prescribers. Most didn’t comment, but some expressed surprise that they were prescribing more opioids than their colleagues. Others said that their patients are not at risk for long-term opioid use, although data shows that 6% of people who receive opioids after a surgery will go on to use them long term. 

“I can absolutely tell you I don’t have even 1% who become long-term opioid users,” said Nebraska surgeon Janet Grange.

Oregon surgeon Audrey Garrett, was surprised to learn that she was a top prescriber, and equally surprised to hear that 6% of patients given opioids will develop long-term use. 

“That is a shocking number,” she said. “If it’s true, it’s something we need to educate physicians on much earlier in their medical careers.”

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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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