The Opioid Crisis: Patient Safety and Education

This national public health emergency affects millions of Americans. The amount of opioids prescribed tripled between 1999 and 2015, and these medications, though quite effective for some types of pain, pose serious risks. Along with dependence and addiction, users may also experience a lesser-known adverse effect that can actually increase the amount of pain they feel (a condition called opioid-induced hyperalgesia).

In 2016 more than 11 million people reported misusing prescribed opioids like hydrocodone, oxycodone and codeine, many of them by taking a friend's or relative’s pills to relieve pain. Heroin and now fentanyl use has soared in recent years as opioid overprescribing was reduced. 

While in the last few years, public attention has shifted from the opioid epidemic to the Covid pandemic, opioid-related mortality has continued to increase at a significant rate. An estimated 2.7 million people report suffering from an opioid use disorder, with more than 180 people dying every day from an overdose. From 2019 to 2020, opioid overdose deaths in the United States increased by almost 30% to the highest numbers ever recorded.

Opioid And Pain Management Resources

When it comes to surgery and opioids, our surgeons and anesthesiologists are experts in employing a variety of pain-management treatments. Learn more about how HSS approaches and prioritizes pain management, best practices for safety and care and much more:

Understanding and Treating Pain

Understanding and Treating Pain

• Pain Management Myths and Facts
• Pain management physician Robert S. Griffin, MD, PhD, explains that there are several common misperceptions about pain management that are important to dispel so that patients can make informed medical decisions. Read more to find out what is myth and what is fact.
• Coping With Pain Caused by a Chronic Disease
  This article includes a brief discussion on why opioids are not advised to treat the chronic pain associated with rheumatic diseases like rheumatoid arthritis.
• The Complex Problem of Pain
  This article includes a brief discussion on the benefits, risks and side effects of opioids.
• Speaking of Pain: How to Help Your Doctor Help You
  This article on the chronic pain associated with rheumatoid arthritis (RA) includes a brief discussion on why opioids are not advised and provides information on alternative pain medications for RA.
• Opioids: Understanding Addiction Versus Dependence
  This article explains how a patient can be dependent on a drug, such as an opioid, but not be addicted to it, and why this distinction is important.
• Opioid-Induced Hyperalgesia
  Seth A. Waldman, MD, Chairman of the HSS Controlled Substances Committee and Advisor of Opioid Prescribing Practices at HSS, discusses a condition in which long-term opioid can result in a person's increased sensitivity to pain. 
• Post-Laminectomy Syndrome
  This article discusses a condition where patients have residual pain even after a spinal surgery, and why it is important to reduce opioid use as much as possible after surgery to avoid opioid-induced hyperalgesia, addiction and other side effects.

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Preoperative evaluation is a complex and holistic process that considers not only medical, surgical and social issues, but also factors in each patient’s past experience with pain. This evaluation is now a part of our workflow, reflecting our overall goal of providing the best care with the least risk.

”

Seth Waldman, MD
Chairman of the HSS Controlled Substances Committee,
Advisor of Opioid Prescribing Practices at HSS

 

 

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