Why should a breast biopsy patient receive the same amount of opioids as someone who’s had both knees replaced? That one-size-fits-all approach to pain management has contributed to the nation’s current opioid crisis — surgeons have been flying blind, often writing oversized scripts based on habit or opinion. What if your physicians had a guideline for how many opioids to prescribe for a particular procedure? Many say proscriptive prescribing would limit the number of unused and unneeded pills that continue to fuel the epidemic.
A prominent leader in that charge is Chad Brummett, MD, co-director of the Michigan Opioid Prescribing Engagement Network (OPEN), a program launched in 2016 with support from the Michigan Department of Health and Human Services, Blue Cross Blue Shield of Michigan Value Partnerships and the Institute for Healthcare Policy and Innovation at University of Michigan. Michigan OPEN’s goal is to standardize post-op and acute care opioid prescribing.
The research group rose out of a desire to cover up a blind spot in the CDC’s 2016 opioid prescription guidelines, which were released in response to the epidemic of overdose deaths. “I’m a big fan of the guidelines, but they’re really about chronic pain and chronic pain management,” says Dr. Brummett. “They have one line for acute pain that simply says to prescribe for the lowest amount possible for the shortest time possible. While I agree with that recommendation, it doesn’t necessarily direct surgeons on how to prescribe.”
Michigan OPEN has released evidence-based opioid prescription guidelines for 25 surgeries, and is in the process of adding more (see “Proven Prescribing Recommendations”).
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