Making Pain Management Safe: It’s a Complicated Task

This article is by Kerry Nenn and published by Rehabs.com

 

More than two million Americans suffer from substance abuse issues related to prescription painkillers and this epidemic takes the lives of more than 90 Americans every single day.

These alarming statistics led researchers to ask: How do we make pain management safe? Specifically, how can we balance opioid prescription length and the risk of dependence?

Establishing a Balance

Some states have already taken action, limiting initial prescription lengths to less than a week. Policy makers have also created drug monitoring programs to keep a more careful watch on potential substance abuse issues, like doctor shopping. However, lawmakers and healthcare providers still have few guidelines about appropriate prescribing of opioids after surgery.

Some physicians create their own policies to balance pain management and the risk of opiate dependence. Dr. Aleksey Lazarev, orthopedic surgeon at Lenox Hill Hospital in New York City, discusses this issue with patients. Before surgery, he lays out expectations for post-op pain and recovery. He prescribes short-acting narcotics for only a few days after surgery. The prescription is usually for no more than 20 pills, and he doesn’t give refills.

Here’s the question, though: Is this the right answer for everyone?

The Answers Are Pretty Hazy

To provide the healthcare industry with better parameters for prescribing opiates, researchers investigated the issue of addiction risk. The CDC reports:

• Six percent of patients prescribed opioids for pain were still on an opioid one year later. This includes patients who received as little as a single day’s supply.
• Patients who took the drugs for more than a week were much more likely to experience long-term use. Among these patients, 13 percent were still on opioids a year after their initial prescription.

A recent study by the Center for Surgery and Public Health at Brigham and Women’s Hospital offers similar, but varied, results. These researchers studied opioid medication prescription patterns following common surgeries. They applied a mathematical model to determine the ideal length of painkiller prescriptions and generated this formula:

• Four to nine days of opiate prescription for general surgery
• Four to thirteen days for women’s health procedures
• Six to fifteen days for musculoskeletal procedures

Pain is Different for Everyone

The problem is that people aren’t math equations. That’s why studies have found multiple answers, and those answers continue to change. In the end, this is a very complex issue that requires individualized solutions. No amount of research can guarantee a certain formula will work for everyone.

The truth is, one person could take Oxycodone or another prescription pain medication for two weeks and remain addiction-free, while another might take the same medication for a week and develop an opioid dependency. Everyone’s addiction switches are different.

So how long can you safely take painkillers? Turns out the answer ultimately depends on you.