How Many Pain Pills Do Patients Really Need?
Match the number of opioids to the procedure to stop overprescribing.
A
n abdominal hysterectomy is a lot more painful procedure
than a thyroidectomy, so why write for the same number of
opioids for each patient? To control the hysterectomy
patient's post-op pain, 35 Vicodin or 25 Percocet seems appropriate.
The thyroidectomy patient will only need 10 Vicodin or 5 Percocet.
We know, however, that many surgeons routinely prescribe more pain
pills than patients will need, either out of habit or out of fear that
they'll get more phone calls for refills or inadequate pain control if
they write for fewer opioids.
You can help your surgeons rethink their prescribing practices. As
part of the Opioid Prescribing Engagement Network (OPEN), a group
working to prevent the overprescribing of opioids, I helped develop
the opioid prescribing recommendations we listed for you on the
opposite page. The recommendations are meant to ensure patients
receive the right amount of pills
to manage the pain they're likely
to experience after several com-
mon procedures. We'll soon add
recommendations for hip and
knee replacement patients (opi-
oidprescribing.info).
Right-sizing opioid use not
only limits opioid-related post-
op complications such as nau-
sea and intestinal issues that
can lead to readmissions, but
also helps curb the opioid epi-
demic. As we know, surgeons
Safety
Michael Englesbe, MD, FACS
• ON HAND
Research has shown
that patients will take
the number of pills
they're prescribed.
2 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • S E P T E M B E R 2 0 1 8
