Choices Matter: Changing the Perioperative Experience for Patients to Reduce Opioid Risks T he numbers continue to validate the severity of the opioid epidemic – keeping this issue center stage among patients, physicians and the media. In fact, the CDC reports that 91 people die every day in the United States from an opioid overdose.1 And it’s not just overdose – but addiction contributing to the problem. Recent research found that an alarming 10 percent of patients reported becoming addicted or dependent on opioids following surgery.2 Concerns over addiction and dependence are weighing on patients as 37 percent report that addiction is a top concern when scheduling a surgery. The concern is more prevalent in men, with 41 percent of men and 34 percent of women concerned about becoming addicted to opioids.3 Reducing the risk of opioid use, abuse and dependence is a conversation that should remain at the forefront of this epidemic for both in the consumer and clinical space. There are several ways to mitigate opioid use, including education, offering alternatives and assessing the perioperative medicine model. The perioperative discussion has become even more important in recent years as additional options have become available to minimize postsurgical pain before a surgeon even finishes his or her procedure. Easing patients’ concerns about postsurgical pain cannot be lost in this conversation, however. Patients and physicians are eager and open to trying non-opioid options. According to the Choices Matter survey, 79 percent of patients reported that they would choose a non-opioid option over opioids and 70 percent of surgeons would do the same if they knew it could effectively manage their patient’s pain.4 By collaborating together, patients and physicians can develop pain management plans and implement contracts that allow physicians to prescribe fewer painkillers and reduce opioid risks that can occur in short term usage. We acknowledge that some surgical procedures are needed immediately and some require opioids post-surgery; however having a conversation and discussing options, when available, is important since research finds some patients are delaying surgery due to fear of pain. Patients and physicians deserve a choice – which thematically was a cornerstone of the Choices Matter campaign that the American Society for Enhanced Recovery and Pacira Pharmaceuticals embarked on last year. The unbranded education campaign was developed to empower and activate patients, caregivers and physicians to proactively discuss ASER ALERT • VOLUME 2, ISSUE 1 • aserhq.org postsurgical pain management, including non-opioid options before surgery. It is imperative that the medical community continue to work together to change the perioperative and postoperative experience and create viable alternatives to effectively manage pain. To do so, collaboration among patients, physicians and the community at-large will need to continue to work together on the front lines of this epidemic to combat it head on and educate one another on the non-opioid options available to reduce the risks of opioid addiction. If an option is not available, having the conversation about postsurgical pain (how it will be managed before, during and after surgery) is still a great way to start. n References 1. CDC Report. https://www.cdc.gov/ drugoverdose/epidemic/. Accessed on January 27, 2017. 2. Choices Matter Survey. Released on August 1, 2016. Report available upon request. 3. Choices Matter Survey. Released on August 1, 2016. Report available upon request. 4. Choices Matter Survey. Released on August 1, 2016. Report available upon request. 5
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