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Stopping opioid addiction at one key source: the hospital

Shefali Luthra, Kaiser Health News on

Published in News & Features

It may not be rocket science, but a group of surgeons at the University of Michigan's Michigan Medicine have devised a strategy to curb the nation's opioid epidemic -- starting at their own hospital.

Their findings appeared online Wednesday in the journal JAMA Surgery.

Opioid addiction has been deemed a "national emergency." It's estimated to have claimed 64,000 lives in 2016 alone. And research shows that post-surgical patients are at an increased risk of addiction because of the medication they receive to help manage pain during recovery.

It's a simple enough idea: Surgeons should give patients fewer pills after surgery -- the time when many people are first introduced to what can be highly addictive painkillers. They should also talk to patients about the proper use of opioids and the associated risks.

That seemingly small intervention could lead to significant changes in how opioids are prescribed and make inroads against the current epidemic, said the researchers.

"The way we've been prescribing opioids until this point is we've basically been taking a guess at how much patients would need," said Jay Lee, a research fellow and general surgery resident at the University of Michigan, and one of the paper's authors. "We're trying to prevent addiction and misuse by making sure patients themselves who are receiving opioids know how to use them more safely -- that they are getting a more consistent amount and one that will reduce the risk of them getting addicted."

 

The researchers identified 170 patients who underwent gallbladder surgery and surveyed them within a year of the operation -- asking how many pills they actually used, what pain they experienced after surgery and whether they had used other painkillers, such as ibuprofen.

They used those findings to create new hospital guidelines that cut back the standard opioid prescription for gallbladder surgeries.

Then, they analyzed how patients fared under the new guidelines, tracking 200 new surgery patients who received substantially fewer pills -- an average of 75 milligrams, compared with 250 mg previously. Despite getting less medication, patients didn't report higher levels of pain, and they were no more likely than the previously studied patients to ask for 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 negative side effects.

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