Surgeons Try Prescribing Fewer Opioids To Lower Addiction Risk
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It may not be rocket science, but several surgeons at the University of Michigan have devised an approach to help curb the nation’s opioid epidemic – starting at their own medical center.
Opioid habit has been deemed a “public health crisis” by the White House. It’s estimated to possess claimed 64,000 lives in 2016 alone. And research shows that post-surgical patients are in an increased risk of addiction as a result of the treatments they receive to greatly help manage pain during recovery.
To lower the chance, there’s a straightforward remedy: Surgeons should provide patients fewer pills after medical procedures – the time when many people are first introduced to what can be very addictive painkillers. They should also talk to patients about the proper use of opioids and the linked risks.
That seemingly small intervention could bring about significant alterations in how opioids are prescribed and help to make inroads against the current epidemic, said the researchers. Their findings were released Wednesday in the journal JAMA Surgery.
“The way we’ve been prescribing opioids until this aspect is we’ve basically been taking a guess at how much patients would want,” said Jay Lee, a research fellow and general medical procedures resident at the University of Michigan, and among the paper’s authors. “We’re trying to prevent habit and misuse by producing sure patients themselves who are receiving opioids understand how to utilize them more safely – they are getting a more constant amount and one that will reduce the chance of them getting addicted.”
The researchers recognized 170 individuals who underwent gallbladder surgery and surveyed them within a year of the procedure about how many pills they actually applied, what pain they experienced after surgery and whether they had used various other painkillers, such as ibuprofen.
They used the findings to create new medical center guidelines that scale back on the typical opioid prescription for gallbladder surgeries.
Therefore, they analyzed how patients fared under the fresh approach, tracking 200 medical procedures patients who received substantially fewer pills – an average of 75 milligrams of opioid painkillers, particularly oxycodone or hydrocodone/acetaminophen. Previously, the average medication dosage was 250 milligrams.
Despite getting much less medication, patients didn’t report higher degrees of pain, plus they were no more likely than the previously studied patients to require prescription refills. They were also likely to actually use fewer pills.
The takeaway: After surgery, patients are getting prescribed more opioids than necessary and doctors can reduce the amount without experiencing harmful side effects.
Within five months of the new guidelines taking effect at Michigan’s University Hospital, surgeons reduced the quantity of prescribed opioids by about 7,000 pills. It’s right now been a year because the change took result, and the researchers estimate they possess curbed prescriptions by about 15,000 pills, said Ryan Howard, an over-all medical operation resident and the paper’s lead author.
The reduction provides real implications.
“This really shows in an exceedingly methodological way that we are drastically over-prescribing,” said Michael Botticelli, who spearheaded drug control policy under the Obama White House, including the administration’s response to the opioid crisis.
“Not only carry out we must reduce the source to prevent future addiction, but we need to minimize opportunities for diversion and misuse,” he said.
More hospitals are starting to turn in this direction, Botticelli said. He right now works the Grayken Centre for Addiction at Boston INFIRMARY, which can be trying to systematically decrease opioid prescriptions after surgeries.
Meanwhile, 24 states have passed laws to limit just how many pills a health care provider prescribes at once, in line with the National Conference of State Legislatures.
The researchers also created “common sense” talking points for doctors and nurses to use with patients. They incorporate:
Encouraging patients to use lower-power, non-addictive painkillers initial; Warning them about the risks of addiction; and Reminding them that a good sufficient opioid prescription would keep them sense some pain.
The talking points as well offer techniques for patients on properly storing and disposing of extra pills.
“So substantially of this problem could be addressed with alternatives that aren’t complicated,” said Julie Gaither, a great instructor at Yale College of Medicine. Gaither provides researched the opioid epidemic’s implications, though she had not been associated with this study.
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