By Roy Soto, MD
Victory over pain is the greatest gift an anesthesiologist like me can offer his patients. I discovered that firsthand when I switched from general surgery to anesthesiology 20 years ago.
During surgery, the medications and techniques used to anesthetize a patient are carefully controlled. Anesthesiologists consider the patient’s medical history and coordinate with the operating surgeon. It’s after surgery that problems often begin. At that point, pain treatment relies heavily on prescription opioids – too heavily for many Americans.
Of the roughly 51 million Americans undergoing low-risk inpatient surgery each year, more than 80% are prescribed opioids. This is far too high an exposure risk to these potentially addictive drugs. The situation is just as alarming in primary care, where as many as one in four patients receiving long-term opioid treatment struggle with addiction.
The stories of addiction in recent years may be contributing to patients’ increased awareness. A deeper understanding, however, can help inform their individual pain management choices.
So, where do we go from here?
The long-term solution lies with getting more information to patients about opioid risks and building awareness of non-opioid alternatives for pain relief. In the spirit of patient-centered medicine, pain management approaches should be chosen by patients through shared decision making with their doctors.
That’s why the Non-Opioid Directive Act, now pending in Congress, is so pivotal. This legislation would ensure that patients are made aware of the range of pain treatment options and their respective risks, then empower patients to choose the option they believe is best. Specifics of the bill include:
- The right for patents to indicate up-front that they do not want to be treated with opioids.
- A requirement that physicians fully disclose the potential risks of opioid-based treatment.
- A provision that allows physicians to prescribe opioids in emergency situations.
Opioids can be effective in some circumstances. But patients desperately need individualized care that’s right for them, their pain and their level of risk. The Non-Opioid Directive Act is an important step in that direction.
Roy Soto, MD, is a board-certified anesthesiologist practicing in Royal Oak, Michigan and a member of the Alliance for Balanced Pain Management.