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Treatment for addiction takes many forms and depends on the needs of the
individual. In accordance with the American Society of Addiction Medicine, we offer
information on outcome-oriented treatment that adheres to an established continuum of
care. In this section, you will find information and resources related to evidence-based
treatment models, counseling and therapy and payment and insurance options.
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The Perelman School of Medicine at the University of Pennsylvania, in collaboration with researchers from the University of Toronto, released a study on the increased prescriptions of opioids to patients undergoing low-risk surgeries. This coincides with the Centers for Disease Control and Prevention’s (CDC) publication of new guidelines regarding opioid prescription in cases of chronic pain.
The pool of patients, observed from 2004 to 2012, went in for one or more of the four low-risk procedures: carpal tunnel release, hernia repair, knee arthroscopy, and gallbladder removal. None of the patients evaluated had filled an opioid prescription within six months preceding their surgery.
The study, published in the Journal of the American Medical Association (JAMA), found that four in five patients who underwent common surgeries filled their opioid prescriptions, the majority of which were for Percocet or Vicodin, within seven days following their discharge.
Opioid addiction is an alarming concern in the United States, with the National Institute on Drug Abuse (NIDA) estimating that 2.1 million people suffer from substance use disorders relating to prescription opioids. According to NIDA, the abuse of opioid prescriptions often segments into heroin abuse because heroin is cheaper and more readily available as compared to prescription opioids.
An Increase in Prescriptions and Prescriptions Filled
The increase in the amount of opioids dispensed by physicians across all the procedures throughout the 8-year period is significant. When the prescription drug was converted to a morphine equivalent, the study noted an increase of 18 percent for patients undergoing knee arthroscopy. Additionally, a growth in the number of patients filling their opioid prescriptions was observed. Prescriptions filled for gallbladder removal went from 75.2 percent in 2004 to 80.7 percent in 2012.
Mark Neuman, a senior author on the study and director of the Penn Center for Perioperative Outcomes Research and Transformation, expressed his concerns about the data trend.
“These data show us a concerning trend,” said Neuman. “The growth we observe over time in opioid prescribing after surgery occurs against the backdrop of a major public health crisis of prescription opioid abuse. Additional work is needed to understand how postoperative opioid prescribing patterns might play into this epidemic, and to define better strategies for treating postoperative pain safely and effectively in the future.”
The recently published CDC guidelines directly encourage physicians to explore options other than opioids to help alleviate chronic pain. They further reinforce that opioids should be used in situations where the benefits outweigh the risks of potential abuse.
“The opioid abuse epidemic can impact any of us, so it requires all of us to bring about sustainable change,” said Dr. Harshal Kirane, director of addiction services at Staten Island University Hospital.
The Dangers of Prescriptions Following Low-Risk Surgery
This past December, the CDC declared that the mortality rate from opioids and heroin was at a record high in 2014. They maintain that more than three out of five drug overdose-related deaths were the result of opioids. This confirms the prescription drug epidemic worsens daily.
“Past misuse of prescription opioids is the strongest risk factor for heroin initiation and use,” the CDC reported in its Morbidity and Mortality Weekly Report, “specifically among persons who report past-year dependence or abuse.”
In a study on the long-term analgesic use after low-risk surgery, it was noted that 7 percent of patients are prescribed opioids within seven days of a low-pain surgery and more than 10 percent of them continued to use these medications a year later. Moreover, patients who were initially prescribed opioids of low potency switched to more potent opioids, such as oxycodone, within one year of their procedure.
“Though these pain medications are very necessary, many doctors tend to overprescribe them in their pain-management regimen,” said Dr. Ashish Sahasra, an endodontist at Premier Endodontics in Garden City, N.Y.
The urgency in the reevaluation of opioid prescription to patients of low-risk surgeries is self-evident. “More than 40 Americans die each and every day from prescription opioid overdoses,” CDC director Dr. Tom Frieden said during a conference.
He added: “Increased prescribing of opioids – which has quadrupled since 1999 – is fueling an epidemic that is blurring the lines between prescription opioids and illicit opioids.”
Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.
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Alam, A. et al. (2012, March 12). Long-term Analgesic Use After Low-Risk Surgery. Retrieved from http://archinte.jamanetwork.com/article.aspx?articleID=1108765
Bernstein, L. (2015, December 18). Deaths from opioid overdoses set a record in 2014. Retrieved from https://www.washingtonpost.com/news/to-your-health/wp/2015/12/11/deaths-from-heroin-overdoses-surged-in-2014/
National Library of Medicine. (2016, March 15). CDC Issues Tough New Guidelines on Use of Prescription Painkillers. Retrieved from https://www.nlm.nih.gov/medlineplus/news/fullstory_157775.html
Wunsch H. et al. (2016, March 15). Opioids Prescribed After Low-Risk Surgical Procedures in the United States, 2004-2012. Retrieved from http://jama.jamanetwork.com/article.aspx?articleID=2503506&utm_source=Silverchair_Information_Systems&utm_campaign=Tuesday_March_15_2016&utm_content=olf&cmp=1&utm_medium=email#ArticleInformation
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