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The opioid fraction taken by most surgeries



Sunday, November 7, 2018 (HealthDay News) – Surgery patients typically use only a quarter of their opioids prescribed for postoperative pain, a new study found.

And those remaining pills present a risk of misuse, addiction and overdose, said University of Michigan researchers.

"It's remarkable to see the major discrepancy between the prescribed amount and the amount of patients actually taking," said study author Dr. Joceline Vu. She is a surgical resident and researcher at Michigan Medicine.

"This is not a phenomenon of a few external surgeons – it has been seen across the country and in many operations," Vu said in a press release from the University.

In the study, the researchers analyzed data from nearly 2,400 patients who had one of 12 common types of surgery at 33 Michigan hospitals. On average, patients took only 27% of opioids (such as OxyContin) prescribed for them. However, for every 10 additional prescribed pills, the patients took five of them.

The median number of prescribed pills was 30, and the median used was nine, the researchers found.

Patients who had a hernia repair surgery – either open or minimally invasive surgery – took most of the opiates, while those who had the appendix or the thyroid had at least found the results.

But the size of the prescription of opiates was a more important factor in the number of pills a patient took than their pain scores, the intensity of their operation and personal factors, the authors of the study said.

According to the first author of the study, Dr. Ryan Howard, "As we tell patients what pain they can expect after surgery and how many pills they give, we have set expectations – and what the patient expects to play a huge role in post-operative pain experience. So if I get 60 pills of pain, I think I have to take many of them.

Howard, a Michigan surgical resident, added: "We hope that by taking the forefront of the gap between prescription size and actual use, we can empower surgeons to change prescribing habits and be a better steward for the patient their wider community. "

The report was published on 7 November in a journal JAMA Surgery.


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