115 Americans die each day from the opioid epidemic according to the Centers for Disease Control and Prevention. Heightened concerns over opioid addiction have many doctors questioning their own role in this widespread and ongoing crisis. Pain has been touted as the “fifth vital sign”, but doctors, dentists, and outpatient physicians have begun to reassess their recommendation of opioid drugs like Percocet, hydrocodone and Vicodin.
University of Michigan’s Opioid Prescribing Engagement Network (OPEN), a group aimed at reducing persistent use and excessive prescribing of opioids for acute care, have found that some health professionals are able to reduce opioid painkiller prescriptions by one-third while maintaining proper pain management for post-surgery patients. This is because patients are often overprescribed painkillers. For instance, it is estimated laparoscopic gallbladder removal patients are prescribed on average nearly 40-50, 5-milligram hydrocodone pills. However, the number of pills actually consumed by patients interviewed were only about 6. This leaves a lot of unused opioids in the home of many patients. The fear is excessive prescription leads to persistent opioid use by patients who have never used opioids before surgery. Although it’s not entirely clear how many patients become dependent or addicted to opioids after first receiving a post-surgery prescription, OPEN has continued its research developing guidelines for the prescribing of opioids.
When OPEN implemented these guidelines at Michigan Medicine, the average prescription for gallbladder removal dropped by about 15 pills. These highly addictive opioids were replaced by an increase in nonopioid pain relievers prescriptions like acetaminophen or ibuprofen, which more than doubled. In terms of pain management, 86 percent of patients who received less opioids reported the same level of pain control. A major concern of doctors is what happens with unused opioids. The goal of OPEN’s guidelines is to keep as many unused opioid pills out of circulation as possible. OPEN has estimated that over 13,000 excess opioid pills have been kept of circulation since the implementation of their guidelines at Michigan Medicine.