Docs in Surgery

Having surgery? Beware of risk from post-op opioids

Two VA patients were discharged from the hospital on the same day. One, a 70-year-old retiree, had an arthritic knee replaced. The other, a 24-year-old auto mechanic, underwent a hernia repair.

The woman and man (names are being withheld to protect patient privacy) came to the operating room for very different reasons. However, both left the hospital with an item that patients all too often take home: a sizable supply of prescription opioids. One year after surgery and unknown to their surgeons, both are still taking painkillers.

No one goes into an operation hoping to be on opioids a year later. In some cases, chronic use of opioids after surgery is unavoidable. But all too often, opioids are excessively prescribed. Up to 75 percent of patients, if not more, after surgery have leftover painkillers.

In many cases the continued use of these drugs after surgery doesn’t receive the same scrutiny as when they are used for chronic pain. Even for standard procedures, like a hernia repair, there is wide variation in the amount of opioids that patients take home — variation that is hard to explain based on patients’ characteristics, or the scientific evidence.

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