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Archive March 2018 XIX, No. 3

Anesthesia Alert: Limit Opioids - or Avoid Them Altogether

Painkillers are often not the answer to post-surgical pain.

James Grant

James Grant


Hospital Patient
OVERPRESCRIBING This patient was likely discharged with a prescription for 30 or more opioid painkillers when as few as 5 would have sufficed.

Those of us in surgery must do our part to fight the opioid crisis that's killing thousands of Americans every year. Our job is simple: Administer fewer opioids during surgery and discharge patients with a prescription for as low a dose as possible for the shortest time possible. Or with no prescription at all.

We in the surgical community must also recognize that we have unintentionally contributed to the opioid epidemic by overprescribing. Most people who abuse narcotics got their first pills as legitimate prescriptions — oftentimes after surgery or a procedure. But there are virtually no guidelines in place to help anesthesiologists and surgeons choose an appropriate amount for a given procedure or patient. Patients are therefore often prescribed more pills than needed.

Even today, with the addiction and overdose problem showing no signs of abating, many patients are discharged with a prescription for 30 or more prescription painkillers when a fraction of that number will suffice. Nobody needs a prescription for that many Vicodin, hydrocodone or oxycodone for post-surgical pain. Yes, patients should take opioids for the worst pain, but they should only take them for a day or two. There are effective pain management alternatives and many people don't need opioids at all, or at least should drastically reduce the amount they take.

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