Tag Archives: dependency

post-surgical painkiller addiction

Should Hospitals be Accountable for Post-Surgical Painkiller Addiction?

Patients checking into a hospital for surgery is a very common occurrence. After their procedure, they want and expect to be given enough pain medication to be kept comfortable while they recover.

Often, the pain medication given by the surgeon and other medical providers is an opioid. They are prescribed for severe pain and are considered effective at providing temporary relief. The problem is that a number of doctors are prescribing these powerful painkillers without understanding how quickly patients can develop a dependency and thus start to experience withdrawal symptoms. When patients ask about how to taper off the medication when they are recovered from their surgery, they are often not getting enough information or accurate instructions.

Post-Surgical Opioid Dependency

Some doctors and hospital administrators are now asking the question, If some patients are becoming addicted to opioids starting with a stay in a hospital for surgery or another procedure, should the hospital be held responsible? Is the addiction a medical error in the same category as an infection acquired in hospital?

At least three physician/executives with the Hospital Corporation of America have argued that the answer should be, “Yes.” Drs. Michael Schlosser, Ravi Chari and Jonathan Perlin have stated that since this type of addiction arises during a hospital stay and is a “high-cost and high-volume condition,” and that it can often be avoided by implementing and applying new guidelines for patient care.

The doctors say that although it would be difficult for hospitals to monitor all the patients being given opioid pain medications in the weeks and months after their release, hospitals should have a system in place to try. The issue of long-term opioid use as a hospital-acquired condition opens the door for standards of care to be put in place to help patients manage their pain and protect them from coming to future harm.

Holding Hospitals Responsible May Have Financial Impact

Compensation and bonus structures at many hospitals are tied to patient satisfaction surveys, and that has been cited as one reason for doctors to continue over-prescribing drugs in an effort to keep patients happier. Less painkillers initially may mean that more patients experience some additional discomfort, and even though they may be saving lives from potential addiction, the doctors could wind up getting lower reviews and thus less pay.

Majority of Surgical Patients Have Drugs Left Over

Studies have revealed that the majority of patients (between 67-92 percent) have painkillers left over after surgery. Approximately 10 percent of patients need what is described as “intense pain management,” but it is difficult for physicians to identify which patients need this level of pain relief.

There are no set guidelines for what types of opioids should be prescribed after surgery, the typical dose that should be prescribe or how long patients should take them. In 2016, the Centers for Disease Control (CDC) released prescribing guidelines for opioids for chronic pain patients, but they only addressed acute pain briefly.

A new study published in September found that the optimal time for opioid use after surgery is between four and nine days.

Doctors Focus on Reducing Painkiller Use in Chronic Pain Patients

chronic painA recent study of patients taking prescription narcotics for chronic pain conditions focused on reducing the amount of drugs they were using. The research team, headed by Dr. Beth Darnall, was able to successfully cut down the amount of medication being taken without increasing the intensity of their pain.

Dr. Darnall is a Clinical Associate Professor in the Division of Pain Medicine at Stanford University. She is the author of the book Less Pain, Fewer Pills and is focused on the psychology of pain. Her work is important not just for the help of individual patients to reduce their symptoms, but it can also hold the key to helping to eliminate some of the opioid dependency in our country that starts with chronic pain.

Typically, patients believe that if they take less medication that they will experience more pain, but this research has thus far shown positive results. “A lot of people falsely assume that if you taper off opioids your pain will spike, your depression and anxiety will increase and you will fall apart,” said Dr. Darnall. “They think opioids are holding them together. Our data suggests otherwise.”

The psychology of pain shows that people have different reactions to their pain and can help control their symptoms based o their mindset. Dr. Darnall works with patients to “harness the power of their mind-body connection to reduce suffering, pain and need for medications.”

With overdose deaths reaching new heights around the country, there has been considerable focus of late on reducing the influence and damage that opioids can cause. The CDC recently issued new prescribing recommendations, which included finding non-opioid treatments for mild to moderate chronic pain.

Helping to cut the overall number of pain pills being taken can have a dramatic effect on improving the quality of life for potentially millions of people as well as help save thousands more from addiction.

Drivers Under the Influence of Xanax Increase

xnxXanax, or alprazolam, is an anti-anxiety drug that is widely prescribed to people who struggle with mental health-related issues. Many people suffer from such severe anxiety disorders that they are required to take the medication on a daily basis. Other people only use Xanax when they are in situation that produces anxiety for them, like a plane or an important event. Alprazolam is also a drug that causes impairment, and people taking it should not be driving or operating machinery.

Xanax is one of the most abused prescription drugs on the market, and many people develop a severe dependency to the drug, whether taken by itself or in combination with other substances. The millions of people who have taken the drug, either abusing it or using it by prescription, has increased the number of people cited for driving under the influence of the drug. In fact, Xanax has actually become the second-most common drug in DUI cases, having surpassed marijuana.

“I have no doubt that people who use Xanax for anxiety get some relief from these drugs. But we should steer away from medicines that require daily use for an extended period of time,” explained Peter Hendricks, a chemical psychologist. His point being that drugs like this can cause a serious dependency and addiction that can become more damaging than the original problem. Many professionals are now recommending finding other ways to deal with mental health problems, if possible, before resorting to medications that have a high potential for abuse.