1 in 16 post-surgical patients become chronic opioid users
Many common operations require minimal opioids when leaving the hospital, and some can be managed with non-opioid alternatives. Yet, there is wide variation in opioid prescribing by surgeons. In 2015, nearly half of U.S. opioid overdose deaths involved a prescription opioid. Surgeons prescribe the most opioids in narcotic naïve patients and recent data shows that 70-80% of these prescribed opioids go unused after surgery.
Despite this, many patients continue to be discharged after a c-section, laparoscopic cholecystectomy, tubal ligation, etc. with 30 or 60 opioid pills when they only need 0-10 pills. One problem is that the ideal range of post-surgical opioid medications after common standardized operations remains unknown. Moreover, surgeons who are over-prescribing are often unaware that they are outliers.
To address opioid over-prescribing after surgery on a national level, we propose to use an established physician benchmarking program, developed by Dr. Marty Makary to identify the highest outlier surgeons in opioid prescribing for common operations. Surgeon specific data reports will then be sent to outlier surgeons by the U.S. Pharmacy Quality Alliance (PQA), our fully committed specialty association partner. Second, we will create a task force of expert surgeons, pain specialists, nurses, residents, and patients to identify pain medication prescribing best practices for the same common operations.
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WHAT ARE OPIOIDS?
Opioids are a class of drugs that include prescription pain relievers, heroin, and synthetic opioids such as fentanyl. A few of the commonly prescribed opioids include: oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine, and morphine. These drugs work by acting on opioid receptors in the nervous system in order to block pain and create a general calming effect. Opioid prescriptions are generally safe when taken in short stints, but due to their euphoric effects, they are often susceptible to being misused.