opioids with benzodi-
azepines or alcohol,
which can lead to
fatal respiratory
arrest.
Counsel patients and their caregivers on how to properly store and
dispose of controlled substances. It's not always the patients who
receive prescribed opioids who end up misusing them; friends and
family members with access to unsecured or leftover medications are
also at risk. Similarly, warn patients about taking nonprescribed opi-
oids they "borrowed" from a friend or relative.
2. Screen for risk factors
Check if patients have a history of opioid abuse or chronic use to
determine if greater care is needed to monitor their current usage or if
the medications should be avoided altogether. Review patients' med-
ical records for information about prior use of prescribed opioids and
check state-run databases to see if patients have a history with con-
trolled substances that might not be noted in their personal records.
Pre-op screening should also include conversations with patients
about elements of their health histories — and the health histories of
their family members — that could make them prone to opioid mis-
use, including substance use disorder, excessive alcohol and tobacco
consumption, and history of depression or anxiety.
3. Communicate with compassion
Post-op phone calls should include a discussion of any ongoing issues
patients are having with the healing process, assessment of the pain
level they're experiencing and checking to ensure they've stopped
using opioids if their pain has resolved. Remember to use compassion
5 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 • J A N U A R Y 2 0 2 0
It's not always the patients
who receive prescribed opioids
who end up misusing them.