New protocols for pain management address addiction potential.
One of the complexities of the ongoing opioid crisis in the United States is that opioids have a legitimate, important role to play in healthcare. As pain management medication, they are incredibly useful, and their effectiveness cannot be overlooked. For people who need to deal with serious pain after surgery, opioids are a great way to get through those initial days until the worst of it starts to subside and they can gradually get off of the medication. However, pain guidelines are an important part of this process.
For someone who is dealing with addiction problems, or has had addiction problems in the past, using opioids when they are prescribed to deal with post-surgery pain is a dangerous step to take. Even though the use of the opioids in this application is legitimate, it can lead the individual down a slippery slope that can result in a long-term addiction problem. For such individuals, finding other ways to manage pain can be an important part of the healthcare process.
It’s no secret that providing opioids for pain management to individuals with a history of addiction is a recipe for trouble. But there hasn’t been a clear process in place for how that pain management should be handled, and what guidelines should be followed. To address this gap, the American Society of Anesthesiologists has recently led an effort to develop new principles for healthcare professionals to use in this process.
The first principle that allows for the rest of the process to work effectively is identification. It’s critical to determine which patients are at risk before going any further, and this requires active screening and watching for risk factors. When someone is identified as at-risk for opioid addiction, or is currently addicted to a substance, the rest of the steps can then come into play.
Success in this realm means working together, so coordinating care between all of the healthcare workers who will be serving a given patient is necessary. Also, these guidelines have directed the concept of using the minimum possible dose of opioids after surgery to lessen the addiction risk.
This is important for opioid-tolerant patients who might have needed a larger dose than normal prior to surgery in order to achieve the desired level of pain relief. That dose should be reduced as quickly as possible post-op, a determination that can only be made on a case-by-case basis when working closely with the patient. Education also plays a role in this framework, as providing people with the information they need to know what the risks are and how to minimize them can help those people take ownership over the process.
To be sure, patients slipping into addiction in the aftermath of surgery is far from the only thing driving the opioid crisis. However, as this issue continues to grip the country, it’s important to fight back on as many different fronts as possible. Every patient that can avoid addiction risk by using other options for pain management is one more that won’t be added to the tragic totals currently being seen in the opioid epidemic.