By Sean Power
Opioids–drugs such as oxycontin, vicodin, percocet, and fentanyl–have recently garnered mainstream attention as more people become dependent and addicted to the painkiller in epidemic proportions. Perhaps it is because 1 in 5 become long-term users of opioids with a 10-day supply; perhaps because sales of prescription opioids in the U.S. nearly quadrupled from 1999 to 2014; or, perhaps simply because chronic opioid use often begins with opioid usage for acute (short-term) pain–whatever the reason, the opioid epidemic is front and centre in public health discourse.
The Physician-Patient Alliance for Health & Safety, a nonprofit focused on improving patient safety in hospitals, has worked to improve opioid safety after surgery. Throughout our work, it has become apparent that we should be thinking about pain management throughout the entire continuum of care: before an operation, during the procedure, after the procedure during recovery at the hospital, and upon discharge.
Patients need to think about pain throughout the continuum, too. That’s why we’ve collected a series of consumer-facing resources on opioid safety.
1. Medicines to Treat Pain
This fact sheet provides an overview of opioids, how they work, when doctors prescribe them, alternatives to opioids, and how to decide whether you should use opioids.
2. Avoid Opioids for Most Long-Term Pain
This guide summarizes the advice of experts from the Centers of Disease Control and Prevention, doctors’ groups, and Consumer Reports Best Buy Drugs. It talks about the dangers of opioids, its side effects, and how to use them safely. It also provides examples of other non-drug and non-opioid therapies for a variety of types of chronic pain.
3. PCA Safety Checklist
In addition to the risk of long-term use–either dependence on or addiction to opioids–the painkillers can be dangerous for acute usage, as well.
One way for doctors to help you manage pain after surgery while you recover in your hospital bed is to prescribe something called patient-controlled analgesia (PCA). Patients get hooked up to an infusion pump, called a PCA pump, and can self-administer a dose of painkillers prescribed by their physician by pushing a single button.
The PCA pump has threshold limits to prevent administering too much medicine too quickly–in theory. But, since every patient is different, these pumps can pose risks.
The PCA Safety Checklist is a free tool developed in collaboration with patient safety experts that helps clinicians keep patients safe when they receive opioids via a PCA pump. Ask your doctor to use the PCA Safety Checklist if there is a possibility you are prescribed PCA after surgery.
If you or a loved one is about to undergo surgery and the doctors may prescribe opioids, or if you have already been prescribed opioids, share these resources with your doctors and ask about their pain management and opioid safety plan.
Patients and clinicians interested in opioid safety may also wish to follow the PPAHS blog and subscribe to the podcast.