Scientists from the University of Dundee found that targets to eliminate pain after surgery are a major cause of the opioid crisis in several countries.
The report brings together global evidence detailing the role of surgery in the opioid crisis. The researchers conclude that pain management has been a big contributor to the crisis due to inappropriate prescribing of opioids.
The research is published in The Lancet and was conducted by Professor Lesley Colvin et al.
Chronic pain often begins as acute postoperative pain that is difficult to control and develops into a persistent pain condition with features that are unresponsive to opioids.
In response to this pain, clinicians often prescribe higher levels of opioids, but this can lead to tolerance and opioid-induced hyperalgesia (a counterintuitive increase in pain in line with increased opioid consumption), creating a cycle of increased pain and increased opioid use where pain remains poorly managed.
The US opioid crisis began in the mid-1990s and early 2000s when inadequate pain relief was seen as a marker of poor quality healthcare.
Opioids are now one of the most commonly prescribed medications in the US with similar, although less marked, trends in other high-income countries, including the UK.
Comparatively, many low-income countries worldwide have little access to opioids and cannot provide appropriate pain relief.
Studies between 2011-2017 found that 67-92% of US surgery patients reported not using all of their opioid tablets, typically leaving 42-71% of their prescribed pills unused.
In the study, the team says chronic post-surgical pain is a growing problem as the population ages and more operations are carried out. It can occur after any type of surgery.
They called for interventions including specialist pain clinics, drug monitoring policies, improved medical training in opioid prescribing, and new pain management methods including the use of alternative pain relief medication to curb the crisis.
If you care about pain, please read studies about the most effective drug for opioid use disorder, and this drug may relieve painful ‘long covid’ symptoms.
For more information about pain, please see recent studies about new method to help relieve back pain, and results showing this pain medication may increase your hip fracture risk.
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