In a new study, researchers have discovered the major cause of the opioid crisis.
They found that inappropriate pain management after surgery causes most of the opioid abuse.
The research was conducted by a team led by Monash University in Australia.
They found that chronic pain after surgery is a growing problem as people are getting old and more surgeries are done. The pain can occur after any type of surgery.
It is estimated that every year there are 320 million people having surgery, and chronic pain occurs in 10% of cases.
Chronic pain often begins as acute pain that is difficult to control, and then it develops into a persistent pain condition that may be unresponsive to opioids.
To deal with this pain, doctors often prescribe higher levels of opioids, but this can lead to tolerance and opioid-induced hyperalgesia.
This can create a cycle of increased pain and more opioid use but the pain remains there.
In the US, the opioid crisis began during the mid-1990s and early 2000s, when inadequate pain relief was seen as a marker of poor quality healthcare.
Opioids now are one of the most commonly prescribed drugs in the USA and the UK.
In surgery, opioids could help reduce the dose of general anesthetic needed, and appropriate opioids after surgery can help improve patients’ feelings.
But the persistent use of opioids after surgery can lead to long-term opioid use and misuse.
The researchers found that in the USA, opioid prescribing for minor surgery has increased and the risk of opioid misuse increases by 44%.
A recent study of more than 155,000 patients showed that opioid prescriptions after minor kidney surgeries increased from 2004-2012 and that the average daily dose of opioid also increased by 13%.
Another study comparing one US and one Dutch hospital found that 77% of patients undergoing hip fracture repair in the US hospital received opioids, but none did in the Netherlands hospital.
In addition, 82% of US patients received opioids after ankle fracture repair and 6% of Dutch patients received opioids after the surgery.
Despite the differences, patients in both countries have similar levels of satisfaction with pain management.
The team also found that between 2011-2017 about 67-92% of US surgery patients reported not using all of their opioid tablets. They often left 42-71% of their prescribed pills unused at home.
The researchers call for a comprehensive approach to reduce these risks of opioid overuse.
They suggest doctors reduce opioid prescriptions and increase use of alternative medications.
They also suggest patients reduce leftover opioids in the home and get to know the risks and benefits of opioids.
Future work needs to help effectively manage opioid tolerance and opioid-induced hyperalgesia.
The leader of the study is Professor Paul Myles from Monash University.
The study is published in The Lancet.
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