Prevention: The Word That Will Help Fight the Opioid Crisis

As an orthopedic surgeon, I’ve seen firsthand what millions of Americans know to be true: We’re in the grip of an opioid crisis that is ruining lives and tearing apart families across our nation.

The depth of the crisis is clear, as is the responsibility policymakers have to address it with meaningful solutions. That’s a message that I will be carrying from my practice and my patients in Indiana to Capitol Hill this week, because I want to make sure our lawmakers have the same motivation to take action and promote prevention of needless opioid exposure.

My goal for my patients is to provide them with clinically appropriate pain management after any procedure. Yet across the health care sector, there is the overprescription of billions of opioids each year. In the surgical setting, data show that 90 percent of patients receive opioids to treat their pain, despite the availability of alternative pain management options. Research indicates as many as 6 percent of surgical patients will become persistent opioid users. Simply put, the operating room is a gateway to the opioid epidemic.

Lawmakers can help close that gateway by focusing on one element that has been largely overlooked in the discussion about the opioid crisis: prevention. Concrete action is needed to help prevent unnecessary opioid prescriptions and give patients choices in pain management.

When we consider the opioid crisis in America, and the clear need for a greater focus on prevention, the numbers make a strong case:

According to the Centers for Disease Control and Prevention, until recently, the number of opioids prescribed in the U.S. has quadrupled in the past 15 years — even though there has been no change in the amount of pain American patients report.

— In 2016 alone, 3 million Americans who were prescribed an opioid after surgery were still taking them three to six months later. That same year, of the 115 Americans who died each day from an opioid overdose, nearly half were using prescription opioid medications.

— It’s estimated that 300,000 fewer people would become persistent opioid users each year if surgery-related prescribing could be cut by as little as 10 percent — translating into less addiction and dependence and reduced exposure to opioid-related side effects.

Here is where a great opportunity lies. If we can expand our national dialogue to include the value of and need for prevention, and if we can take concrete legislative action, we can make a real difference.

This week, I’ll be joining a panel of experts and patient advocates for a Hill briefing on postsurgical, nonopioid pain management options. I plan to communicate the reality that patients and the physicians who treat them face too many avoidable hurdles when it comes to more easily accessing Food and Drug Administration-approved opioid alternatives.

These effective alternatives already exist to help patients manage their pain following surgery. But the trick will be to change the conversation — soon — so that opioids are no longer the only “go-to” resource for surgeons and their patients to treat postsurgical pain that cannot be otherwise controlled.

This can be achieved. The burden falls on federal lawmakers to get involved by acting now to pass bipartisan legislation that will encourage greater choices for patients to consider nonopioid options — thereby helping prevent opioid addiction before it starts.

More specifically, legislators can act to increase access for opioid alternatives for patients and the surgeons like me who treat them. By marrying this improvement with developing guidelines for opioid prescribing, we have a real opportunity to help doctors rely on alternatives to opioids as a matter of course.

This change alone has the power to make opioid-free surgeries a possibility for patients across the country and exponentially reduce the rate of opioid addiction in the process. It’s not every day a single bill or vote can save so many lives, but here is lawmakers’ chance to do just that.


Dr. Stephen Mitros is an orthopedic surgeon from South Bend, Indiana, who will be participating in a Capitol Hill briefing on increasing patient access to nonopioid pain management on Wednesday.

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