In 2016, the opioid epidemic in the U.S. gained attention from the media and government as an immediate problem plaguing our nation. The Obama administration took several actions to tackle the opioid epidemic, including broadening access to medication-assisted addiction treatment, improving prescription painkiller monitoring, and expanding research on pain treatment, opioid misuse, and overdose.
While the opioid epidemic is often viewed as a drug issue, it is an overall healthcare issue. The best way to mitigate its impact is to reform the structural issues within our healthcare system, including the treatment and management of patients’ pain. Non-opioid pain management options for acute and chronic pain are a viable solution to help combat the opioid epidemic.
A Better Way to Manage Post-Operative Pain
Each year, more than 73 million surgeries are performed in the U.S., and up to 75 percent of patients experience pain after surgery. Post-operative pain management is a critical element of recovery, but pain is often inadequately managed with an overreliance on narcotics versus a multimodal pain management strategy.
Non-opioid therapies such as Halyard Health’s ON-Q Pain Relief System can be administered for post-operative pain management following a surgical procedure.
The ON-Q Pain Relief System continuously delivers a regulated flow of non-opioid local anesthetic to a patient’s surgical site or in close proximity to nerves. The suite of products includes pain pumps, pump accessories, and peripheral nerve block accessories, designed to provide effective, non-opioid pain relief for patients.
All modes of post-operative analgesia come with risks, but a significant percentage of patients receiving opioids experience adverse events, including constipation, nausea and opioid dependence.
A study published in Pharmacotherapy found that 13 percent of surgical patients who received opioids experienced adverse events. Opioid related adverse events was associated with a 55 percent longer length of stay, 47 percent higher costs of care, 36 percent increased risk of 30-day readmission, and a 3.4 times higher risk of inpatient mortality.
According to the Centers for Disease Control and Prevention (CDC), the rate of opioid prescribing steadily increased from 2007 to 2012 and was highest among pain medicine, surgery, and rehabilitation. The CDC also reported that more than 165,000 people died from overdoses related to opioid pain medication between 1999 and 2014.
Multimodal therapies involving post-operative pain pumps, such as ON-Q, have been proven to be more effective and lower risk compared to opioids. In fact, with the use of ON-Q pumps, patients experience a significant decrease in pain scores. Continuous peripheral nerve blocks (CPNBs) also offer patients up to 48 hours of pain relief, which may lead to improved pain relief, reduced length of stay, and accelerated post-operative recovery.
Combating Chronic Pain Without Opioids
An episode of acute pain or post-surgical pain can sometimes lead to chronic pain. According to a study from Kapural et al., “pain persistence lasting longer than three months is defined as chronic; if left untreated, the pain can be debilitating, unrelenting, and impact the patient’s overall quality of life.”
In March 2016, the CDC developed guidelines that urge doctors to avoid prescribing opioids for patients with chronic pain, noting that the risks of such drugs outweigh the benefits for some people. Thus, the need for non-opioid therapies for chronic pain management, such as Halyard’s COOLIEF Cooled Radiofrequency (RF) treatment, is crucial.
COOLIEF Cooled RF is a minimally-invasive outpatient procedure that uses cooled radiofrequency energy to target and lesion the sensory nerves causing pain.
COOLIEF Cooled RF can provide chronic back pain patients up to 24 months of pain relief, improved physical function and reduced use of medication. Using a non-opioid therapy, such as COOLIEF Cooled RF, may eliminate negative side effects associated with opioids, such as nausea and addiction.
In order to tackle the opioid epidemic, clinician and patient education about non-opioid alternatives for chronic and acute pain is imperative. Many patients may not completely understand the risks of taking opioid painkillers, and even more might not be aware that there are non-addictive alternatives.
In fact, 72 percent of patients would choose non-opioid pain medication for post-surgical pain management if offered the option. With more patient and clinician education, we can change the way we manage pain in the U.S. and work to curtail the opioid epidemic.
Kevin Friedman, DO, has been the medical director at Halyard Health since 2014, and was medical director at Kimberly-Clark Health Care. Previously, Friedman was a flight surgeon for the U.S. Navy