to manage post-op pain without opioids, but that it was also safe and
beneficial for patients to do so. During our study, we were shocked to
find that patients who didn't receive opioids ambulated easier, report-
ed less pain and anxiety, and returned to work sooner. It's been 2
years since I've given any opioids to patients who've undergone mini-
mally invasive surgery.
Do you think some surgeons overprescribe
opioids because it's an easier way to control post-op pain?
Yes, but that's not a perception based on reality. Changing a surgeon's
prescribing habits is challenging, but it can be done. I've convinced 9
of my colleagues to stop using opioids with monthly emails to let
them know how many opioids they prescribed and how their rates
compared with other surgeons. I also texted surgeons on the high end
of the prescribing list to ask why they weren't cutting back on opioid
usage. The persistent communication paid off.
Should opioids still be part of effective pain management proto-
cols?
That needs to be determined on a case-by-case basis. Do I still give
them to patients? Sure. But I've found a vast majority do much better
with alternative therapies. An increasing number of patients are aware
of the risks associated with opioids, and don't want to take them.
That's also been helping to decrease the number of scripts surgeons
write.
OSM
Dr. Davies (daviesbj@upmc.edu) is a professor at the University of
Pittsburgh School of Medicine and chief of the urology section at UPMC
Hillman Cancer Center in Pittsburgh, Pa.
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