Newsflash! If the medical community acts more mindfully and responsibly in handing out pain medication, that will go a long way toward helping us make greater progress in fighting the plague of addiction. It’s a sane, logical message, but unfortunately is taking longer than we’d like to spread through the hospitals, clinics and doctors’ offices around the country. That’s why I’m hopeful that a recent initiative by the University of Virginia Health System (UVA), in which patients’ pain scores improved considerably even as doctors gave fewer opioids, can serve as a role model for the rest of the nation.
The UVA anesthesiologists reviewed a total of 101,484 surgeries between 2011 and 2015 in which patients were sedated. During this time frame, doctors were encouraged to minimize the use of pain medication to no more than was absolutely necessary. As a result, the average amount of opioids given per surgery declined a whopping 37 percent. At the same time, surgical patients self-rated average pain score, on a scale of 0-10, declined from 5.5 to 3.8, a 31 percent improvement.
How can we explain this? One of the key doctors in the study, Dr. Marcel Durieux, pointed out two major reasons why that was likely the case. First, it has been clearly proven that opioids themselves make patients more sensitive to pain. So, by reducing the dosages, the opiates were actually more effective. Second, was the increased use of non-opioid pain medications like licodaine and acetaminophen (up over 120%). As it turns out, in most instances, these lower level medications for pain control were more than sufficient to get the job done.
“There is very clear evidence that people can become opioid dependent because of drugs they get during and after surgery,” remarked Dr. Durieux. “I think that by substantially limiting opioids during surgery, we’ve made an important step in addressing that problem.”
The UVA initiative was implemented as a reaction to America’s opioid epidemic. The intention was to be proactive in stemming the tide of a process that regularly, although unintentionally, creates new opioid addicts. Interestingly enough, along the way, the UVA researchers not only proved their point, that they could effectively reduce opioid dependence by being more careful in their prescription practices, but they did even more. By demonstrating that a reduction of opiate use combined with an increase in non-addictive alternatives is actually MORE effective at addressing pain, they have created a model of safer best practices for the medical community to follow in the implementation of all pain management throughout the country.