MedicalResearch.com Interview with:
Chad M. Brummett, M.D.
Director, Clinical Anesthesia Research
Director, Pain Research
Department of Anesthesiology
Division of Pain Medicine
University of Michigan Medical School
Ann Arbor, MI 48109
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The opioid epidemic has received tremendous attention in recent years, but most of the focus has been on chronic pain, opioid abuse and overdose. Far less attention has been paid to the importance of acute care prescribing (e.g. surgical pain) in patients that are not chronic opioid users.
We found that 5-6% of patients not using opioids prior to surgery continued to fill prescriptions for opioids long after what would be considered normal surgical recovery. Moreover, the rates of new chronic use did not differ between patients having major and minor surgeries, suggesting that patients continue to use these pain medications for something other than simply pain from surgery. Building on other work by our group, and the few additional studies done on the topic to date, these data suggest that pain medications written for surgery are a major cause of new chronic opioid use for millions of Americans each year.
MedicalResearch.com: What should readers take away from your report?
Response: At the moment, clinicians should be cautious about prescribing and consider the potential risks of opioids after surgery, but there are no tools currently available to allow a clinician to screen patients. While it is questionable as to whether opioids should be used to treat chronic pain, opioids are still very good medications for treating acute pain after surgery or injury. Pain control is important for surgical recovery, but patients must remember that surgery does hurt and some pain is to be expected. However, in the days or weeks after surgery, patients should wean off of opioids even if they continue to have some pain. If their pain becomes chronic, they should seek additional care and consider other medications and alternatives to opioids.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Although we find these data very interesting and believe that we have described an underappreciate problem in acute care, prospective data are needed. More granular data of patient characteristics such as pain, mood, sleep, and social support are needed to better understand which patients are at risk for chronic use and abuse. We believe that the appropriate prescribing for acute care offers a preventative model to address the opioid epidemic.
Disclosures listed in the manuscript, but not are relevant this paper.
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Brummett CM, Waljee JF, Goesling J, Moser S, Lin P, Englesbe MJ, Bohnert ASB, Kheterpal S, Nallamothu BK. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg. Published online April 12, 2017e170504. doi:10.1001/jamasurg.2017.0504
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