Opioid Stewardship and the Surgeon Invited Commentary Invited Commentary Patrick R. Varley, MD; Brian S. Zuckerbraun, MD The opioid epidemic in the United States is a critical public tient expectations and the proposed plan, (U) use multi- health issue. There were 33 091 deaths from opioid over- modal therapy, (C) controlled prescribing, and (E) early referral doses in 2015, which represents a nearly 400% increase to pain specialists. since 1999. The role of prescription painkillers in this epi- Surgeons must appreciate patient risk factors for devel- demic cannot be ignored. oping dependence, including male sex, age older than 50 years, More than half of these and a history of depression or other drug abuse. By educat- Related article deaths in 2015 involved pre- ing patients and discussing expectations, surgeons can pre- scription opioids, and the pare patients for what to expect with respect to postopera- total amount of oxycodone hydrochloride and hydrocodone tive pain and management plans. It is important for patients bitartrate sold to retail pharmacies has increased by nearly to understand that the goal of postoperative pain manage- 300% from 2000 to 2016. In this issue of JAMA Surgery, ment is not to be “pain free” but
JAMA Surgery – American Medical Association
Published: Feb 13, 2018
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