Outpatient Surgery Magazine

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.

Issue link: http://magazine.outpatientsurgery.net/i/1198986

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Page 37 of 58

dards to specific patients requires more investigation. "That's the next step," says Dr. Hannon. "The long-term goal is to create individualized opioid prescriptions based on patient factors, the type of surgery they had, their risk for pro- longed opioid use and whether they've had opioids for previous surger- ies," he adds. Dr. Hannon envisions scenarios where a doctor can, based on that personal information and other factors such as the patient's pain perception, be much more precise and about opioid prescriptions. Dr. Brummett believes opioid-related patient prescreening and opi- oid-sparing regimens like Enhanced Recovery After Surgery (ERAS) aren't pervasive right now. "I don't think anyone is doing this really well," he says. "Finding non-stigmatizing ways to screen patients effi- ciently is not a simple thing to do." He advises to watch for certain factors associated with new per- sistent use of opioids: anxiety, depression, sleep disorders, chronic pain conditions, history of abuse of alcohol and other substances, and tobacco use. Another important factor: remote opioid use. "We often know a person isn't using opioids, but we don't know if they've used them previously for a prolonged period of time," he says. "If they have, there's a better chance they will abuse opioids than would an opioid-naïve patient. Indeed, it's vital to delineate the patient's risk factors associated with dependence. "The No. 1 predictor of post-operative opioid use is pre-operative opioid use," says Dr. Hannon. 'A long way to go' Researchers, physicians, professional societies and governmental agen- cies are just several of the many parties looking to curb access to opi- oids by standardizing prescriptions. The overprescribing problem touch- 3 8 • 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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