The More Post-Op Opioids Prescribed, The More Patients Take

The More Post-Op Opioids Prescribed, The More Patients Take

Most post-operative patients are prescribed far more opioid painkillers than they need, according to an important new study of opioid prescribing vs. actual need based on pain levels.

The study of 2,392 post-op patients in Michigan found that the more pills they went home with, the more they consumed, and the more they had left over to stash in the medicine cabinet.

Unfortunately, prescribing too many pills means patients often wind up taking far more than they should, risking complications when mixed with other drugs or alcohol, not to mention dependence and addiction.

Leftovers are risky

Stashing leftovers for later means more chances they’ll be given to, or stolen by, friends or family, which spreads the risk around.

“Overall, we are prescribing much, much more than patients are consuming,” said Dr. Joceline Vu of the University of Michigan in Ann Arbor. “We know people don't take all of those pills. We know some stick around in patients’ medicine cabinets.”

Dr. Vu, an author of the study, told MedPage Today that surgeons often don't know how much of a prescription a patient uses. “Unlike a prescription for back pain, we don't say, ‘Take three of these per day.’ We say, ‘Here's 30 pills. Take them if you need them,’” she said.

Only use a third

The study revealed that post-op patients used roughly a third (9 pills) of the average, or median, prescription of 30 hydrocodone/acetaminophen pills (Vicodin, Lorcet).

But the study also revealed that patients would consume more if they got more – 50 percent more for every additional pill prescribed above that median of 30 pills.

In other words, if they received 40 pills to start with – 10 more than the median – they’d take 14 total pills – 5 more than they would have if they’d only been given 30.

It’s like a big plate of food

 “It's like ordering a large plate for dinner,” Dr. Vu said. “You're probably going to eat more than if you had a small plate.”

And that’s not a good idea when we’re dealing with opioids, not in this era of record breaking opioid addiction and overdose deaths:

  • An extraordinary number of Americans suffering from opioid addiction, including many who die from overdose, become dependent after taking legitimately prescribed opioids.
  • A large number of those people become dependent taking someone else’s left-over prescription opioids – either “borrowed” or stolen.
  • We all know that the more opioids you take, the greater your chances of opioid dependence and addiction.

Here’s another important point: Most people don’t know that another recent, very important study, found that most chronic pain patients can do just as well with over-the-counter painkillers like Advil or Tylenol as opioids. The only caveat was that the treatment must be carefully personalized for each patient.

So what’s the takeaway?

If you’re a general surgery patient, be sensible and be careful. Don’t take more opioids than you really need. Ask your doctor about Advil and Tylenol and even aspirin sooner rather than later.

And never drink alcohol or take other drugs with opioids unless cleared by your doctor.

If you’re the prescriber, also be sensible and be careful. Don’t prescribe more opioids than are absolutely needed. Patients can always request a refill if they think they need more. But they may do perfectly well on OTC pain meds.

Finally, if you or someone you care for is in need of assistance for an opioid use disorder or for any substance disorder, don’t hesitate to call Novus. We’ll help you get pointed in the right direction.

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