In a new study from the University of Michigan, researchers found that an opioid-sparing strategy could help patients manage pain after surgery without opioids.
They found that more than half of the people in the study did not need opioids after their operations.
The opioid epidemic has become a public health crisis in the U.S.
While doctors have been writing fewer opioid prescriptions over the last several years, research has shown that new opioid prescriptions by surgeons increased by 18% from 2010-2016.
Many surgeons now are working to change their prescribing practices.
One approach is to use pain management strategies that include fewer or no opioids at all for surgical patients.
In the current study, the team wanted to find out if one such strategy would work for patients undergoing six different surgeries.
They tested 190 patients undergoing six surgical procedures.
These people received specific instructions about pain control, pain expectations, and counseling to learn to manage pain without opioids after their surgery.
After their operations, the patients received prescriptions for 650 mg of acetaminophen and 600 mg of ibuprofen.
They also got a small “rescue” prescription of opioids just for uncontrolled breakthrough pain.
At their later clinic visits, the patients were told to take acetaminophen or ibuprofen every 6 hours and to stagger these medications every 3 hours for maximum continuous pain control.
The researchers found that more than half of the patients used no opioids after their operations and almost all of the patients said their pain was manageable.
The team explains that a big root cause of the opioid epidemic is opioid-naïve patients getting exposed to opioids and then cannot stop taking the drugs after the surgery.
These patients then move on to chronic opioid use, abuse, addiction, and overdose.
Opioid-naïve patients are patients who don’t need to use opioids to control their pain.
The researchers said that fewer opioids are only one component of the larger pain management strategy.
It is important to give the best pain care for each patient while reducing their risk of opioid addiction.
In future work, the team will expand the list of surgical procedures from six to 18. They will implement the strategy to other institutions across the state.
The leader of the study is Michael Englesbe, MD, FACS.
The study is published in the Journal of the American College of Surgeons.
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