Opioids After Surgery: Give Less, Educate More

Giving patients fewer opioid pills after surgery and educating them about baseline pain relief options may help lower the chances of patients developing postoperative narcotic addiction, found researchers at Emory School of Medicine.

The results, based on surveying patients who were undergoing ACL reconstruction surgery, were published in the Journal of the American Medical Association.

Emory chief of sports medicine and professor of orthopaedics John Xerogeanes, a coauthor of the study, believes there is a significant psychological component to the findings.

“It appears that explaining to patients before the surgery that they should take narcotic pain medicine only if their pain is intolerable makes a difference,” he says. “Then after the procedure, when you recommend they take fewer narcotics, they do.”

The average age of patients in the study was around 20 years. “Minimizing the exposure of adolescents and youth to opiates and left-over pain medication after surgery is a step in the right direction given the current opioid epidemic,” Xerogeanes says.

Based on the findings, the researchers suggest reducing the typical opioid dose for postoperative patients by at least half. “We used to give 50 opiate tablets after surgery,” he says. “Now we only give 20.”

Another step, he says, is to examine alternatives such as non-narcotic medications for postoperative care.