A new study shows that a growing opioid crisis is being driven partly by the amount of strong painkillers being given, wrongly, to surgery patients.
The use of prescription opioids more than doubled worldwide between 2001 and 2013.
Researchers who conducted the global study found that an increased reliance on strong opioids was associated with a rising epidemic of their misuse and overdose-related deaths.
The study concluded that 10% of patients experience chronic pain following surgery.
Clinicians often prescribe higher levels of opioids which can lead to increased pain and increased opioid use.
The inappropriate prescription of opioids was found to be a substantial contributor to the opioid crisis.
Professor Lesley Colvin, from the University of Dundee, told Sky News: “Most people are aware of the opioid epidemic in the States, where there’s been a huge increase in strong opioids prescribed for the management of chronic pain.
“One of the things we’re trying to do is find out why that’s happened, so there’s no doubt that one of the contributors has been the people who have had surgery, they need strong painkillers afterwards… those painkillers are sometimes not stopped when they should be.
“People carry on, sometimes with chronic pain, but they carry on with bigger doses of opioids so they end up with the problems of the side effects, misuse problems, tolerance, opioid-induced hyperalgesia (an increase in pain in line with increased opioid consumption).”
The opioid crisis began in the United States in the mid-1990s when inadequate pain relief was perceived as poor quality healthcare. In 2017, President Donald Trump declared the opioid crisis in the US a “national public health emergency”.
Opioids are now one of the most commonly prescribed medication in the USA. Prescriptions for the drugs has also markedly increased in other high-income countries, including the UK.
The study found differences between countries in prescribing opioids after surgery.
Data comparing one US and one Dutch hospital found that 77% of patients undergoing hip fracture repair in the US hospital received opioids, whereas none did in the Netherlands hospital, and 82% of US patients received opioids after ankle fracture repair compared with 6% of Dutch patients.
Despite these differences, patients in each of these countries show similar levels of satisfaction with pain management.
In addition, excessive amounts of opioids are prescribed to US patients after surgery.
Studies between 2011-2017 found that 67-92% of US surgery patients reported not using all of their opioid tablets, typically leaving 42-71% of their prescribed pills unused.
Researchers behind the study have called for a new approach to pain management, with a number of ideas to reduce the risk of opioid use.
They include specialist transitional pain clinics and new ways for opioid-users to dispose of the drugs they don’t need, in an effort to reduce the possibility of misuse and the chance that they end up in the wrong hands.
Professor Colvin said: “There are research gaps that must be addressed to improve the current opioid situation. Firstly, we must better understand opioid tolerance and opioid-induced hyperalgesia to develop pain relief treatments that work in these conditions.
“We also need large population-based studies to help better understand the link between opioid use during surgery and chronic pain, and we need to understand what predisposes some people to opioid misuse so that we can provide alternative pain relief during surgery for these patients.”
“These recommendations affect many areas of the opioid crisis and could benefit to the wider crisis too.”
Source: SKY NEWS