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Illustration:
Jon Krause
Jan. 29, 2018 9:34 a.m. ET
Mark Lockett used to routinely send his patients receiving partial mastectomies home with 30 oxycodone pills. The South Carolina surgeon changed that approach two months ago and now typically gives such patients 10. Oxycodone is an opioid commonly used to treat pain but has a high risk of addiction.
“As a surgeon, I didn’t realize how many of my patients who were never on opioids continued on opioids after surgeries that I had done on them,” says Dr. Lockett, an associate professor of surgery at the Medical University of South Carolina in Charleston. “We heavily overprescribe, not intentionally, but because we don’t want patients to hurt, and what we do hurts.”
The opioid epidemic kills on average 115 Americans a day, according to the Centers for Disease Control and Prevention. About 40% of overdose deaths in the U.S. involve a prescription opioid.
Emergency room doctors, dentists and outpatient physicians are curbing prescriptions. And surgeons are rethinking their own prescription practices.
Still, experts say doctors tend to prescribe opioids even when patients don’t ask.
When
Mark Greenberg,
a pain management physician in Ashland, Ore., had arthroscopic knee surgery in 2017 he was surprised he got a prescription for 50 Percocet pills.
“I never filled the prescription,” Dr. Greenberg says. “I certainly didn’t need any pain medications for a relatively painless surgical procedure.”
As a pain specialist, he says he can see how some patients getting such a procedure might need 10 or 15 pills to get them through the first couple of days. But he found 50 excessive.
Many of Dr. Lockett’s fellow surgeons at the Medical University of South Carolina have cut in half or more the amount of opioids given to patients undergoing common procedures such as knee replacements and hysterectomies.
Less Is More
New recommendations call for a smaller number of opioid pain relievers after surgical procedures.
Number of 5-milligram hydrocodone pills
Reccomended prescription
Estimated current prescription
15
Laparoscopic
gall bladder removal
39
15
Laparoscopic appendix
removal
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