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Post-operative opioids need better management - experts

Friday April 12th, 2019

Post-operative patients need access to specialist pain clinics to help prevent dependency on opioids, experts say today.

According to an analysis published by The Lancet, "inappropriate" pain management after surgery is a major cause of the problems with opioids affecting many developed countries.

Some 7.3 billion doses of opioids were issued globally in 2013, according to the analysis, compared with three billion ten years previously.

Experts writing in the journal call for improved medical training in the prescribing of the substances and improved drug monitoring.

In some countries hospitals have faced targets to reduce post-operative pain. Some 10% of patients suffer from chronic pain, according to the analysis.

Professor Paul Myles, of Monash University, Australia, said: “Over the past decade there has been an increasing reliance on strong opioids to treat acute and chronic pain, which has been associated with a rising epidemic of prescription opioid misuse, abuse, and overdose-related deaths.

"To reduce the increased risk of opioid misuse for surgery patients, we call for a comprehensive approach to reduce opioid prescriptions, increase use of alternative medications, reduce leftover opioids in the home, and educate patients and clinicians about the risks and benefits of opioids.”

He added: "Transitional pain clinics are a new approach at bridging the divide, aiming to eliminate overprescribing of opioids after surgery. These clinics could help identify those at risk of chronic pain after surgery, and offer additional clinic visits, review treatment, refer the patient to alternative services, such as rehabilitation, addiction medicine, mental health services, and chronic pain services."

Professor Lesley Colvin, of the University of Dundee, UK, 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."

Lancet 12 April 2019

http://www.thelancet.com/series/Postoperative-pain-management-and-opioids

Tags: Australia | Pain Relief | UK News | World Health

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