All is Well
How the Opioid Crisis Changed Pain Management and How We Can Heighten Our Awareness of Alternatives
BY SANDRA GUY
The tremendous national toll of opioid addiction and overdose deaths continues, even after such deaths soared to a record high during last year’s COVID-19 pandemic.
The overdose deaths skyrocketed to 93,000 nationwide amid the pandemic, according to the Centers for Disease Control and Prevention.
Accusations against several drug manufacturers, accusing them of misrepresenting the risks of their painkilling drugs, will go to trial in April 2021, West Virginia Attorney General Patrick Morrisey announced earlier this month. West Virginia leads the nation in the rate of drug overdose deaths.
The claim gets to the heart of the issue: Painkillers’ routine use in American medicine and their effectiveness — or lack of it.
In the late 1990s, pharmaceutical companies reassured the medical community that opioid pain relievers weren’t addictive, and healthcare providers started to prescribe them at greater rates.
That led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications could indeed be highly addictive.
It’s an especially timely topic, since September marks Pain Awareness Month. Organizations such as the American Chronic Pain Association work to raise public awareness about issues involving pain and pain management.
New research is shedding light on pain remedies’ effectiveness, too.
Many patients who are prescribed opioids after surgery could get the same level of pain relief with non-opioid alternatives such as ibuprofen or acetaminophen without the risk of addiction, researchers say.
“Opioids have been a routine part of postsurgical pain care for decades, but the risk that they could lead to persistent use has been clearly documented,” said lead author Dr. Ryan Howard, a surgical resident at Michigan Medicine, the University of Michigan’s academic medical center in Ann Arbor.
“Perhaps it’s time to make them the exception, not the rule,” he said in a university news release.
Howard and his colleagues analyzed data from more than 22,000 patients who had had surgery comprising gynecological, hernia, gallbladder, appendix, bowel or thyroid.
Opioids were prescribed to 86 percent of the patients, while 14 percent received prescriptions for non-opioid painkillers.
The percentage of patients who sought emergency care for pain was the same for both.
“This study clearly shows no difference in pain, major adverse events or patient-centered outcomes when opioids aren’t prescribed,” said senior author Dr. Mark Bicket, a pain medicine specialist and co-director of the Michigan Opioid Prescribing Engagement Network (Michigan OPEN).
Michigan OPEN researchers also analyzed national insurance claims data on patients who weren’t taking opioids before surgery.
Patients with new persistent opioid use had more hospital and emergency care in the year after surgery than those who filled no opioid prescriptions immediately after their operation, according to the study led by Michigan OPEN co-director Dr. Chad Brummett.
In the June issue of the Journal of Managed Care and Specialty Pharmacy, Brummett’s team reported that patients who started taking opioids after surgery received five times more opioid prescriptions and had much higher overall health care costs than other patients.
The new research heightens the goals of organizations such as the American Chronic Pain Association, which started Partners for Understanding Pain two decades ago.
Stay up-to-date with tips on wisely handling pain issues at https://www.theacpa.org/september-is-pain-awareness-month/.
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