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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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Michigan Value Partnerships and the Institute for Healthcare Policy and Innovation at University of Michigan. Michigan OPEN's goal is to standardize post-op and acute care opioid prescribing. The research group rose out of a desire to cover up a blind spot in the CDC's 2016 opioid prescription guidelines, which were released in response to the epidemic of overdose deaths. "I'm a big fan of the guidelines, but they're really about chronic pain and chronic pain management," says Dr. Brummett. "They have one line for acute pain that simply says to prescribe for the lowest amount possible for the shortest time possible. While I agree with that recommendation, it doesn't necessarily direct surgeons on how to prescribe." Michigan OPEN has released evidence-based opioid prescription guidelines for 25 surgeries, and is in the process of adding more (see "Proven Prescribing Recommendations"). Awareness of the need to right-size opioid prescriptions is growing among surgeons, OR staff, facility leaders and patients, and not a moment too soon. "Becoming a new persistent opioid user is one of the most common complications after elective surgery, and yet it's something we hadn't previously thought about or talked about with patients," says Dr. Brummett. His team reported in 2017 that roughly 6% of surgical patients who pre- sented as opioid-naïve became new persistent users. The research cov- ered both outpatient and inpatient surgeries and, interestingly, the intensi- ty of the procedure didn't matter; the percentage stayed about the same. An important reason for standardizing opioid prescriptions is to elimi- nate confusion and even subconscious behavior by patients. "There's some psychology behind it, in terms of, 'If we give you more, you're going to take more,'" says Charles Hannon, MD, a resident physician in the department of orthopedic surgery at Rush University Medical Center in Chicago, Ill. Dr. Hannon says Rush's clinical trials found that hip and knee 3 4 • 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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