It’s no secret that there’s a countrywide opioid crisis. According to the National Institute of Health, more than 130 Americans die each day from overdosing on some kind of opioid: prescription opioids, heroin, fentanyl, and others. This crisis didn’t come out of nowhere—it’s been brewing for nearly three decades and is a result of a number of different elements: over-prescription by healthcare providers, a lack of awareness about how addictive opioids can be, a disproportionate focus on subjective measures of pain control, and a skewed reimbursement system. With so many contributing factors, it comes as no surprise that there is no easy fix.
Restricting opioid prescriptions has been floated as one viable method for cutting down on opioid related overdoses, and there has been some success here; according to the FDA, the number of opioid prescriptions dispensed by pharmacies is at a 15 year low. But cutting back on opioid prescription has its own unintended and severe consequences:
- People are turning to unregulated, illegal substances (e.g., heroin) as a less expensive and more accessible alternative
- Many people with acute or chronic pain are not getting the treatment they need to function
Recent legislation aimed to address the crisis by limiting opioid prescriptions for acute pain—like the pain that may occur after a surgery—to just seven days. Though this well-intentioned bill is careful to focus solely on acute pain, rather than chronic pain, the potential consequences are problematic across the board.
The National Institutes of Health reported recently that about 25.3 million adults experienced pain every day for 3 months while nearly 40 million adults experience severe levels of pain. For many of these people, opioids are critical to their ability to function on a daily basis.
So how do we solve a national health crisis that affects the lives of so many Americans? It’s going to take a significant amount of collaboration on the part of healthcare providers, insurers, drug companies and governmental regulatory bodies.
For our part, we are determined to help our patients manage chronic or acute pain effectively and responsibly. There are a couple of ways we do that.
While we do use opioids to help patients cope with acute post-operative pain, we often rely on other methods, like individual nerve blocks, epidurals and other types of steroid injections to reduce pain or “numb” a certain area. In fact, regional nerve blocks often mean that patients are completely pain-free for 24-72 hours after surgery. By the time the nerve block wears off, many patients no longer need or want opioids; they are able to find pain relief with over-the-counter medications like Tylenol or non-steroidal anti-inflammatory drugs (NSAIDs).
For patients suffering from severe chronic pain, we do sometimes prescribe (and carefully manage) opioids if other methods are not working and opioids dramatically improve a patient’s quality of life.
As more solutions arise for opioid crisis, we are committed to working with other players in the healthcare space to do our part. As always, patients come first—we’ll continue to explore multiple pain-relief alternatives while also being conscientious and mindful in our use of opioids for pain management.