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The Surgeon's Role in the Opioid Crisis : A Narrative Review and Call to Action

Shadbolt, Cade ; Abbott, J. Haxby ; Camacho, Ximena ; Clarke, Philip LU ; Lohmander, L. Stefan LU ; Spelman, Tim ; Sun, Eric C. ; Thorlund, Jonas B. ; Zhang, Yuting and Dowsey, Michelle M. , et al. (2020) In Frontiers in surgery 7.
Abstract

Over the past two decades, there has been a sharp rise in the use of prescription opioids. In several countries, most notably the United States, opioid-related harm has been deemed a public health crisis. As surgeons are among the most prolific prescribers of opioids, growing attention is now being paid to the role that opioids play in surgical care. While opioids may sometimes be necessary to provide patients with adequate relief from acute pain after major surgery, the impact of opioids on the quality and safety of surgical care calls for greater scrutiny. This narrative review summarizes the available evidence on rates of persistent postsurgical opioid use and highlights the need to target known risk factors for persistent... (More)

Over the past two decades, there has been a sharp rise in the use of prescription opioids. In several countries, most notably the United States, opioid-related harm has been deemed a public health crisis. As surgeons are among the most prolific prescribers of opioids, growing attention is now being paid to the role that opioids play in surgical care. While opioids may sometimes be necessary to provide patients with adequate relief from acute pain after major surgery, the impact of opioids on the quality and safety of surgical care calls for greater scrutiny. This narrative review summarizes the available evidence on rates of persistent postsurgical opioid use and highlights the need to target known risk factors for persistent postoperative use before patients present for surgery. We draw attention to the mounting evidence that preoperative opioid exposure places patients at risk of persistent postoperative use, while also contributing to an increased risk of several other adverse clinical outcomes. By discussing the prevalence of excess opioid prescribing following surgery and highlighting significant variations in prescribing practices between countries, we note that there is a pressing need to optimize postoperative prescribing practices. Guided by the available evidence, we call for specific actions to be taken to address important research gaps and alleviate the harms associated with opioid use among surgical patients.

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publication status
published
subject
keywords
opioids, postoperative opioid use, prescribing practices, risk factors, surgery
in
Frontiers in surgery
volume
7
article number
4
publisher
Frontiers Media
external identifiers
  • pmid:32133370
  • scopus:85081198535
ISSN
2296-875X
DOI
10.3389/fsurg.2020.00004
language
English
LU publication?
yes
id
e892d678-b3f4-46a8-85bb-01421c846872
date added to LUP
2020-04-03 15:02:22
date last changed
2020-04-04 03:00:05
@article{e892d678-b3f4-46a8-85bb-01421c846872,
  abstract     = {<p>Over the past two decades, there has been a sharp rise in the use of prescription opioids. In several countries, most notably the United States, opioid-related harm has been deemed a public health crisis. As surgeons are among the most prolific prescribers of opioids, growing attention is now being paid to the role that opioids play in surgical care. While opioids may sometimes be necessary to provide patients with adequate relief from acute pain after major surgery, the impact of opioids on the quality and safety of surgical care calls for greater scrutiny. This narrative review summarizes the available evidence on rates of persistent postsurgical opioid use and highlights the need to target known risk factors for persistent postoperative use before patients present for surgery. We draw attention to the mounting evidence that preoperative opioid exposure places patients at risk of persistent postoperative use, while also contributing to an increased risk of several other adverse clinical outcomes. By discussing the prevalence of excess opioid prescribing following surgery and highlighting significant variations in prescribing practices between countries, we note that there is a pressing need to optimize postoperative prescribing practices. Guided by the available evidence, we call for specific actions to be taken to address important research gaps and alleviate the harms associated with opioid use among surgical patients.</p>},
  author       = {Shadbolt, Cade and Abbott, J. Haxby and Camacho, Ximena and Clarke, Philip and Lohmander, L. Stefan and Spelman, Tim and Sun, Eric C. and Thorlund, Jonas B. and Zhang, Yuting and Dowsey, Michelle M. and Choong, Peter F.M.},
  issn         = {2296-875X},
  language     = {eng},
  month        = {02},
  publisher    = {Frontiers Media},
  series       = {Frontiers in surgery},
  title        = {The Surgeon's Role in the Opioid Crisis : A Narrative Review and Call to Action},
  url          = {http://dx.doi.org/10.3389/fsurg.2020.00004},
  doi          = {10.3389/fsurg.2020.00004},
  volume       = {7},
  year         = {2020},
}