Surgeons and perioperative opioid prescribing: An underappreciated contributor to the opioid epidemic

Serrell, Emily C.; Greenberg, Caprice C.; Borza, Tudor

doi:10.1002/cncr.33199

Cited by 15 publications

(13 citation statements)

References 40 publications

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“…17,55,56 Though pain management is a core component of ERAS protocols, what constitutes appropriate perioperative pain management and how this is best assessed remains a topic of debate and public scrutiny. 57-59 Overprescribing of narcotics in the perioperative setting has been implicated as contributing to the nation’s opioid epidemic. Opioids were responsible for nearly 70,000 overdose deaths in 2020 alone.…”

Section: Assessment Of Postoperative Painmentioning

confidence: 99%

“…Postoperative pain is a common phenomenon after major surgery that has been suggested to increase the risk for pulmonary complications and the development of chronic pain 17,55,56 . Though pain management is a core component of ERAS protocols, what constitutes appropriate perioperative pain management and how this is best assessed remains a topic of debate and public scrutiny 57‐59 . Overprescribing of narcotics in the perioperative setting has been implicated as contributing to the nation’s opioid epidemic.…”

Section: Assessment Of Postoperative Painmentioning

confidence: 99%

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Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review

Somani

Chiu

et al. 2021

Otolaryngol.--head neck surg.

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Objective Consumer wearables, such as the Apple Watch or Fitbit devices, have become increasingly commonplace over the past decade. The application of these devices to health care remains an area of significant yet ill-defined promise. This review aims to identify the potential role of consumer wearables for the monitoring of otolaryngology patients. Data Sources PubMed. Review Methods A PubMed search was conducted to identify the use of consumer wearables for the assessment of clinical outcomes relevant to otolaryngology. Articles were included if they described the use of wearables that were designed for continuous wear and were available for consumer purchase in the United States. Articles meeting inclusion criteria were synthesized into a final narrative review. Conclusions In the perioperative setting, consumer wearables could facilitate prehabilitation before major surgery and prediction of clinical outcomes. The use of consumer wearables in the inpatient setting could allow for early recognition of parameters suggestive of poor or declining health. The real-time feedback provided by these devices in the remote setting could be incorporated into behavioral interventions to promote patients’ engagement with healthy behaviors. Various concerns surrounding the privacy, ownership, and validity of wearable-derived data must be addressed before their widespread adoption in health care. Implications for Practice Understanding how to leverage the wealth of biometric data collected by consumer wearables to improve health outcomes will become a high-impact area of research and clinical care. Well-designed comparative studies that elucidate the value and clinical applicability of these data are needed.

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Section: Assessment Of Postoperative Painmentioning

confidence: 99%

Section: Assessment Of Postoperative Painmentioning

confidence: 99%

Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review

Somani

Chiu

et al. 2021

Otolaryngol.--head neck surg.

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“…The opioid epidemic is in large part attributed to the introduction of pharmaceutical opioids, which may act as gateway drugs for many [6] . A significant percentage of prescribed opioids are not taken or utilized postoperatively, leading to diversion [ [6] , [7] – 8 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of the Florida law HB21 on opioid prescribing patterns after spine surgery

Geller

Milner

Pandya

et al. 2023

North American Spine Society Journal (NASSJ)

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“…In the last few years, major concerns emerged from other emerging opioid-related side effects, particularly the risk of dependence, abuse, and misuse. The current opioid epidemic, faced by the US, represents a limiting factor, which strongly impacts opioid prescriptions even in other countries [ 6 ]. Several causes are responsible for the opioid crisis outcome including their misuse and/or abuse, as well as social and economic conditions [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Current and Future Therapeutic Options in Pain Management: Multi-mechanistic Opioids Involving Both MOR and NOP Receptor Activation

Coluzzi

Rullo

Scerpa³

et al. 2022

CNS Drugs

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Opioids are widely used in chronic pain management, despite major concerns about their risk of adverse events, particularly abuse, misuse, and respiratory depression from overdose. Multi-mechanistic opioids, such as tapentadol and buprenorphine, have been widely studied as a valid alternative to traditional opioids for their safer profile. Special interest was focused on the role of the nociceptin opioid peptide (NOP) receptor in terms of analgesia and improved tolerability. Nociceptin opioid peptide receptor agonists were shown to reinforce the antinociceptive effect of mu opioid receptor (MOR) agonists and modulate some of their adverse effects. Therefore, multi-mechanistic opioids involving both MOR and NOP receptor activation became a major field of pharmaceutical and clinical investigations. Buprenorphine was re-discovered in a new perspective, as an atypical analgesic and as a substitution therapy for opioid use disorders; and buprenorphine derivatives have been tested in animal models of nociceptive and neuropathic pain. Similarly, cebranopadol, a full MOR/NOP receptor agonist, has been clinically evaluated for its potent analgesic efficacy and better tolerability profile, compared with traditional opioids. This review overviews pharmacological mechanisms of the NOP receptor system, including its role in pain management and in the development of opioid tolerance. Clinical data on buprenorphine suggest its role as a safer alternative to traditional opioids, particularly in patients with non-cancer pain; while data on cebranopadol still require phase III study results to approve its introduction on the market. Other bifunctional MOR/NOP receptor ligands, such as BU08028, BU10038, and AT-121, are currently under pharmacological investigations and could represent promising analgesic agents for the future.

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Surgeons and perioperative opioid prescribing: An underappreciated contributor to the opioid epidemic

Abstract: Opioid prescribing after surgery remains a key contributor to the national opioid epidemic. Direct surgeon engagement and granular data are required to overcome the limited response to current policies.

Cited by 15 publications

References 40 publications

Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review

Consumer Wearables for Patient Monitoring in Otolaryngology: A State of the Art Review

The impact of the Florida law HB21 on opioid prescribing patterns after spine surgery

Current and Future Therapeutic Options in Pain Management: Multi-mechanistic Opioids Involving Both MOR and NOP Receptor Activation

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