MedicalResearch.com Interview with:
Joceline Vu, MD
Department of Surgery
University of Michigan
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: This study examined how much opioid patients use after surgery, and looked at factors that might predispose some patients to use more or less.
Patient opioid use after surgery is an interesting question that’s gained a lot of attention recently, because it’s different from other uses for opioids. If you have chronic pain, you’re probably going to use all of your prescription. But if you have surgery, you may not take all of your pills, and this leaves people with leftover pills that can be dangerous later.
From this study, we found that patients only use, on average, about quarter of their prescription, meaning that a lot of them are left with leftover pills. Moreover, we found that the biggest determinant of how much they used wasn’t how much pain they reported, or any other factor—it was how big their original prescription was.
What this means is that opioid use after surgery isn’t just determined by pain, but also by what surgeons prescribe. It’s important to keep this in mind as we try to reduce unnecessary opioid prescribing after surgical procedures.
MedicalResearch.com: What should readers take away from your report?
Response: Two things: first, doctors are massively overprescribing opioids after surgery to patients. Second, the more we prescribe, the more patients tended to consume. There’s a lot of room for improvement as we first try to cut down on the overprescribing.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: While we’re focused on reducing opioid prescribing after surgery, we need to do it in a safe way that ensures we’re still taking good care of our patients and their pain. That means using guidelines for prescribing that actually take into account how much patients are using after surgery. Our group has used the opioid use data to create prescribing recommendations for specific types of surgery: http://opioidprescribing.info.
MedicalResearch.com: Is there anything else you would like to add?
Response: No disclosures—Thank you for publicizing our work!
Howard R, Fry B, Gunaseelan V, et al. Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan. JAMA Surg. Published online November 07, 2018. doi:10.1001/jamasurg.2018.4234
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