Dr. Luke is board certified in anesthesia and addiction medicine,
and fellowship trained in acute medicine and regional anesthesia. He's
seen and experienced it all in ORs, detox centers and outpatient rehab
centers. "I don't think opioids are bad," he says. "They have a place in
post-op pain management. We don't need to eliminate opioids, but we
do need to reduce the amount used."
About 60% of surgeries performed in the United States are done in
outpatient facilities, according to Dr. Luke, who says that percentage
will only increase. He calls for surgical professionals to standardize
pain management protocols to make sure opioids are used as sparing-
ly as possible.
Dr. Luke has been active in slashing by half the amount of opioids
surgeons prescribe at UPMC. "That's where we needed to get to
immediately," he says. "But there's still more work to do."
The clinical team at Keck School of Medicine at the University of
Southern California in Los Angeles has also made it their mission to
reduce opioid prescription rates and manage surgical pain through
non-opioid alternatives. They implemented an enhanced recovery
program with thoracic surgery about 18 months ago and have since
added 10 service lines to the list. To date, they've decreased opioid
use per service line by an average of 60%. Their efforts, like those at
UPMC, focus on quality patient education, a reliance on regional
anesthesia and an effective mix of non-opioid pain relievers.
1. Prepare patients
The ultimate success of any opioid-reducing program is directly
linked to quality patient education. On the day of surgery, anesthesia
providers at Keck School of Medicine have very frank discussions
with patients about how they can expect to feel after surgery.
"We make it clear that they will have some pain, and outline what
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