Regarding the May 6 article, “DHS Commissioner Jesson outlines state response to opioid addiction crisis”:
I admire Commissioner Lucinda Jesson’s efforts to tackle the opioid abuse crisis head on by implementing stricter measures on opioid prescribing and access. Most lawmakers and medical professionals like me will agree that addressing the issue at the local doctor’s office is a vital first step. But thinking more broadly about the various touch points where patients are exposed to the dangers of opioids, I encourage the commissioner to turn her eye toward an unlikely source: hospitals.
Each year, more than 70 million patients receive opioids in a hospital or clinic following surgery. Alarmingly, research shows that 1 out of every 15 individuals prescribed postsurgical opioids will go on to use them long term. As a hospital-based anesthesiologist specializing in postsurgical pain management, I’ve seen the health care system’s overreliance on opioids first hand.
While opioids have long been considered the most powerful analgesic, their risks should no longer be considered a “necessary evil” given the availability of safer, and equally effective, non-opioid alternatives. Leading institutions across the country are now implementing opioid minimization strategies using what’s called a multimodal pain management approach. Combining long-acting local anesthetics, anti-inflammatory medications, and regional anesthesia, this regimen targets the various pathways of pain. The goal is not only to reduce or eliminate the need for opioids in the immediate hospital setting, but also — importantly — to reduce the reliance on opioid prescriptions written once patients are sent home.
Minimizing patient exposure to these dangerous drugs should be a core objective in any comprehensive plan to fight prescription opioid abuse, and regulations and legislation urging hospitals to adopt opioid-sparing multimodal pain regimens can help achieve this goal. The time has come to move opioids from the frontlines of defense against postsurgical pain to a reserve position, and I encourage Commissioner Jesson to consider the burden of opioids in the acute care setting as she formalizes her response plan.
Dr. Jacob Hutchins, M.D., is the director of perioperative and interventional pain service for the Department of Anesthesiology and the Department of Surgery at the University of Minnesota.
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