Access Now: AORN COVID-19 Clinical Support

Archive February 2019 XX, No. 2

Throw Away the Script

With opioid-sparing surgery, most patients won't need prescription painkillers.

Scott Sigman

Scott Sigman, MD

BIO

Prescription

Becoming an opioid-sparing surgeon was the most liberating thing I've done in 25 years of practice. Why? Because before I started down this revolutionary path, I'd unwittingly become a pain-management specialist. True, I was an orthopedic surgeon and a healer — what I wanted to be — but I was also writing prescriptions for narcotics. And I was writing refills. And I was spending time trying to wean patients off their medications, because 20% were popping them like Jujubes — very early on showing signs of dependence, abuse and addiction. Plus, I was getting calls at all hours of the day and night, and had to be concerned about patients calling me on weekends.

Not anymore. Now, 5 years later, I'm still a healer of knees and shoulders, left and right, but that's it. Not because I don't care about my patients. I care deeply about them. But because, thankfully, we've figured out how to manage and minimize pain, so that they — and I — no longer have to worry about whether opioids might ruin their lives.

It's important to remember just how this profound and deadly opioid crisis came about — how it is that 4 out of 5 heroin users started with prescriptive opioid medications.

It happened because we succumbed to misinformation and an absurd proposition. The misinformation we were fed was that opioids are inexpensive and non-addictive. Both of those assertions turn out to be patently false. The absurd proposition was that we could and should consider pain a vital sign, and that we had to make sure our patients were completely pain-free. We were told, in fact, we would be graded on our work. Pain would be quantified on a 1 to 10 scale, and if our patients weren't zeros or ones, our hospitals could be penalized and our satisfaction ratings would surely plummet.

New to Outpatient Surgery Magazine?
Sign-up to continue reading this article.
Register Now
Have an account? Please log in:
Email Address:
  Remember my login on this computer

advertiser banner

Other Articles That May Interest You

Who Has Access to Your Medications?

Reduce diversion risks with these drug security and disposal solutions.

Pain Is Personal

Patients do well if you do away with a one-size-fits-all approach to managing their post-op discomfort.

What's New in Post-op Pain Management

As opioid prescriptions continue to decline, attention shifts to alternative methods and formulations.