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Special Edition: Opioids - January 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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oid prescribing rates in 2023 will be double what they were in 1995, well before the CDC in 2001 declared pain as the fifth vital sign, a tip- ping point that many experts believe caused healthcare providers to overprescribe opioids to prevent patients from feeling even a hint of discomfort following surgery. Much of the effort aimed at solving the opioid crisis has focused on limiting the prescribing of extended-release opioids to treat chronic pain. But experts realize that chronic pain patients on long-term opi- oids often began with a prescription for an injury or surgery, and never stopped taking them. "If we want fewer Americans to become addicted to opioids, we need much more cautious prescribing for acute pain," says Dr. Kolodny. "That's where surgeons come into play." He says opioid prescribing has been trending in the right direction since peaking in 2012, but also concedes there's plenty of work left to do because physicians in no other country come close to using opi- oids as aggressively as U.S. physicians do. "We must treat pain more judiciously, set patients up with multi- modal analgesics and practice better opioid stewardship," says Dr. Manning. Patients who take opioids as directed aren't contributing to the epi- demic. It's the unused medication left in the medicine cabinet that winds up in the hands of a drug-seeker. Virtually all states have passed laws to limit initial post-op opioid prescriptions to 5 to 7 days and require physicians to reassess patients before they write for a refill. That's a positive development. So is the Opioid Prescribing Engagement Network (OPEN) in Ann Arbor, Mich., a collaboration of healthcare providers, health systems and insurers that's at the fore- front of efforts to prevent chronic opioid use by limiting the number of pills prescribed to individual patients and standardizing amounts 1 2 • 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 A N U A R Y 2 0 2 0

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