geons operate in your ORs
without being creden-
tialed? Would you keep
nurses on staff who don't
meet continuing education
requirements? Of course
not. So why should you let anesthesia providers and surgeons care for
patients if they don't practice what your policies and procedures
preach?
2. Take back the excess. You can limit the unused opioids that
patients store in medicine cabinets, only to wind up in someone else's
hands. It's difficult to change the prescribing habits of your providers
overnight, but you can inform patients about how to safely dispose of
the excess pills they end up not needing. The outpatient pharmacy
that sits a floor below my health system's surgery center installed a
DEA-approved 38-gallon medication disposal box. The labels on every
bottle of opioids we prescribe at the surgery center include a "Take
Back" directive. Patients receive a single sheet that includes bulleted
information about the opioid epidemic and the location of the medica-
tion drop box. We've collected more than a ton of medications, so it's
safe to say the program is working. It wouldn't be difficult to give
your patients information about how to safely store opioids and loca-
tions in your community where they can dispose of unused pills.
3. Monitor usage. Track procedure-specific quantities of opioids used
at your facility. (Researchers at the Michigan Opioid Prescribing
Engagement Network have developed an excellent resource for right-
sizing opioid use based on procedure type: opioidprescribing.info).
Look for outliers among your surgeons and anesthesia providers and
On Point
OP
6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • J U L Y 2 0 1 8
Even seemingly minor
procedures can result
in major addiction.
