Opioids Post Surgery

Over the last year a bright light was focused on a health epidemic that had been brewing under the radar across the country. Opioid addiction has been a quiet but devastating problem for many years. Thanks to elevated attention by the national media, and an announced “war” against it by the White House, the country must now address the use and misuse of pain medication.

Opioids are essential drugs in relieving pain by binding to the opioid receptors in the nervous system. Their use and application range from low dose, non-prescription cough medicine with codeine, to carfentinel which is so powerful it is only available for veterinary use. Other commonly used opioid drugs include morphine, methadone, Buprenorphine, hydrocodone, fentanyl, and oxycodone. Opioid drugs sold under brand names include: OxyContin, Percocet, Vicodin, Percodan, and Demerol.

Of course, heroin is the most notorious illegal opioid and an ongoing scourge, but the opioid problem with which we now wrestle is the legal and illegal use of prescription opioids.

Opioids are highly addictive. Like morphine, they impart an euphoric feeling. That is one of main drivers of its rampant non-medical uses. In the case of medical misuse, patients often extend the use of proscribed opioids to put off the effects of opioid withdrawal, which can be very uncomfortable if not managed correctly.

According to the latest report of the American Society of Addictive Medicine, there are currently more than 2 million people in the United States that are addicted to prescription pain medication. This epidemic is punctuated by the 20,000 deaths that were attributed to prescription drug overdoses.

Opioids are prescribed for moderate to severe pain caused by trauma, diseases such as cancer and rheumatoid arthritis, or post-surgery pain. For medical professionals, this begs the questions of what is the proper utilization of opioids and what is the proper role of medical professionals in overseeing the use of these drugs?

Obviously there is a heightened awareness of pain management by medical professionals in the post-surgery arena. This awareness has prompted the profession to reexamine existing modalities and protocols with the result being an acceptable level of the patient comfort, mitigated side effects of medication, and successful recovery.

A good start in this regard comes from the University of Michigan Medical Center, where for the very first time the medical community is seeking evidence based information as to the correct amount of opioids to prescribe to a surgical patient. This will address the wide spread problem of over prescribing opioids which has led to a flood of millions of unused and misused opiates in the country.

Doctors are also looking at pushing a more comprehensive pre-surgical regimen for patients. Sports medicine has shown that a proper mix of exercise and diet can have a significant impact on the level and duration of post-surgical pain.

The good news in all of this is that the medical profession is moving swiftly to reexamine the use of opioids. Communities are finally addressing the insidious aspects of misuse, and law enforcement is cracking down on the pill mills, and black market that has grown around this epidemic.

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