Surgeons; This study deals with opioid addiction and deadly overdoses escalate into an epidemic across the U.S., thousands of surgeons continued to hand out far more pills than needed for postoperative pain relief, according to a KHN-Johns Hopkins analysis of Medicare data. Many doctors wrote prescriptions for dozens of opioid tablets after surgeries even for operations that cause most patients relatively little pain, according to the analysis, done in collaboration with researchers at Johns Hopkins School of Public Health.
Some surgeons wrote prescriptions for more than 100 opioid pills in the week following the surgery. The total amounts often exceeded current guidelines from several academic medical centers; which call for zero to 10 pills for many of the procedures in the analysis, and up to 30 for coronary bypass surgery.
Surgeons wrote prescriptions
While hundreds of state and local lawsuits have been filed against opioid manufacturers; so claiming they engaged in aggressive and misleading marketing of these addictive drugs; so the role of physicians in contributing to a national tragedy has received less scrutiny. Research shows that a significant portion of people; so who become addict to opioids start with a prescription after surgery.
In sheer numbers, opioid prescribing in the U.S. peak in 2010; but it remains among the highest in the world, according to studies and other data. In 2016, opioids of all kinds were link to 42,249 deaths; so up from the 33,091 report in 2015. The opioid relate death rate jump nearly 28% from the year before, according to the CDC.
Hoping to reduce overprescribing, Makary is preparing to send letters; so next month to surgeons around the country who are among the highest opioid prescribers under a grant he receive from the Arnold Foundation, a nonprofit group whose focus includes drug price issues. (Kaiser Health News also receive funding from the Arnold Foundation.)
“Reducing unnecessary exposure is key to reducing the risk of new addiction,” said former Food and Drug Administration commissioner Scott Gottlieb. In August 2018, when Gottlieb was at the agency’s helm, it commission a report from the National Academy of Sciences on how best to set opioid prescribing guidelines for acute pain from specific conditions or surgical procedures. Its findings are expect later this year.
Some of the higher prescribing surgeons in the KHN-Johns Hopkins analysis reflect on their potential contribution to a national catastrophe and are changing their practice. Johns Hopkins guidelines call for no more than 10 opioid pills following this procedure, while Brummett’s Michigan network recommends no more than 15. Surgeon and researcher Dr. Richard Barth, once a heavy prescriber himself, said that his own experience convince him that physicians‘ preconceptions about how much pain relief is need are often way off.
Indeed, the data analysis show that a significant number of patients; so give prescriptions for opioids never fill them because they don’t need that level of pain relief. Between 2011 and 2016, for example, only 62% of lumpectomy patients; so in the analysis fill prescriptions, similar to hysterectomy patients.
But the KHN-Johns Hopkins analysis of that year’s data; which shows that half of her patients never fill a painkiller prescription; so a fact she acknowledges has change her thinking. They now starting to prescribe less because many patients say; so You gave me too many’ or ‘they didn’t fill it,” she said.