Current treatment strategy leaves room for improvement
Although as many as 99% of postsurgical patients receive an opioid1
Opioids: effective, yet pose concerns for patients and healthcare providers1-4
- Adverse events increase risk of morbidity, delay ambulation, can increase length of stay, and lead to hospital readmissions1,3
- Opioids are not recommended in several high-risk patient populations3
- Opioid-related issues can have a negative impact on patient satisfaction and reimbursement2,4,5
A high potential for misuse, dependency, or diversion creates a societal burden6-8
- 1 in 15 patients prescribed opioids will go on to long-term use or abuse6,7
- In a study (N=250), the average patient consumed 1/3 of their opioid prescription, resulting in a total of 4,639 leftover pills that could be diverted8
- In 2010, approximately 5 million people were classified as opioid abusers9
Test your knowledge about opioids and the opioid crisis in America
For many Americans every year, often, their first exposure to opioids may occur in a short-term care setting, such as a hospital or outpatient clinic. Most individuals accept — and even expect — that they or their loved ones will be sent home with opioids after surgery. However, for many, this has led to a dangerous pathway of dependence.
The reach and the consequences of the opioid crisis continue to shock: Since 1999, overdose deaths involving prescription opioids have quadrupled.10
QUESTION 1 POSTSURGICAL ABUSE: Pill Count
Out of an opioid prescription for 30 pills after surgery, on average, how many were consumed?
The correct answer is 10
So what happens to those leftover pills? The Centers for Disease Control and Prevention (CDC) warns that many people who misuse prescription painkillers use medication that had been prescribed for someone else.
- Office of National Drug Control Policy. 2013 Drug overdose mortality data announced: prescription opioid deaths level; heroin-related deaths rise [press release]. January 12, 2015. http://www.whitehouse.gov/ondcp/news-releases/2013-mortality-data. Accessed May 26, 2016.
- Rodgers J, Cunningham K, Fitzgerald K, Finnerty E. Opioid consumption following outpatient upper extremity surgery. J Hand Surg Am. 2012;37(4):645-650.
- Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2014. NSDUH Series H-48, HHS Publication No. (SMA) 14-4863.
QUESTION 2 POSTSURGICAL ABUSE: Addiction
At 1 year post-surgery, approximately how many patients who underwent elective cervical spine repair surgery were still using opioids?
The correct answer is one-third
Approximately one-third of all patients were still using opioids 1 year after surgery.
- Wang M, Lozen AM, Krebs EE, Laud PW, Nattinger AB. Predictors of 12-month opioid use after elective cervical spine surgery for degenerative changes [abstract]. Spine. 2013;13(suppl):S6-S7.
QUESTION 3 POSTSURGICAL ABUSE: Chronic Users
True or False: Approximately 1 in 15 patients will become chronic opioid users after surgery.
The correct answer is True
1 in 15 patients will become chronic opioid users after surgery.
- Alam A, Gomes T, Zheng H, Mamdani MM, Juurlink DN, Bell CM. Long-term analgesic use after low-risk surgery: a retrospective cohort study. Arch Intern Med. 2012;172(5):425-430.
- Carroll I, Barelka P, Wang CKM, et al. A pilot study of the determinants of longitudinal opioid use after surgery. Anesth Analg. 2012:115(3):694-702.
- Juman R. Why long term use of opioids is not the answer. March 2, 2013. http://www.kevinmd.com/blog/2013/03/long-term-opioids-answer.html. Accessed May 26, 2016.
- National Institutes of Health; National Institute on Drug Abuse. Prescription and over-the-counter medications. DrugFacts. December 2014. https://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications. Accessed May 26, 2016.
QUESTION 4 GROWING EPIDEMIC: Daily Growth
True or False: 5.1 million people are classified as prescription opioid abusers.
The correct answer is True
In 2010, 5.1 million people were classified as prescription opioid abusers. Alarmingly, 2 million were first-time abusers, which equates to approximately 5,500 new abusers every day.
QUESTION 5 GROWING EPIDEMIC: Gateway
What percentage of people who abuse or who are dependent on pain medication go on to use heroin?
The correct answer is 14%
Abusing prescription opioid painkillers, like OxyContin® and Vicodin®, often leads to heroin use. Reports show that heroin is cheaper, easier to obtain, and produces a similar high to opioids.
QUESTION 6 GROWING EPIDEMIC: Sports
What is the risk for adolescent male organized sports athletes to misuse opioid medications to get high as compared with those not involved in sports?
The correct answer is 4x
The odds of male athletes in organized sports using opioids to get high are 4x greater than for those not participating. Furthermore, there is a 2x greater risk for these athletes to be prescribed opioids and a 10x greater risk of their general medical misuse.
- Veliz P, Epstein-Ngo QM, Meier E, Ross-Durow PL, McCabe SE, Boyd CJ. Painfully obvious: a longitudinal examination of medical use and misuse of opioid medication among adolescent sports participants. J Adolesc Health. 2014;54(3):333-340.
QUESTION 7 FACTS IN NUMBERS: The Script
How many prescriptions for opioids were written in the United States in 2012?
The correct answer is 259 million
In 2012, there were enough opioids prescribed in the United States so that every American could have a full bottle of pills — equal to medicating every adult with 5 mg of hydrocodone every 6 hours for 45 days.
QUESTION 8 FACTS IN NUMBERS: Overdose Deaths
True or False: Among people aged 25 to 64 years, car accidents caused more deaths than drug overdoses in 2013.
The correct answer is False
Among people aged 25 to 64 years, drug overdose caused more deaths in 2013 than car accidents. In fact, 78 people die every day in the United States from an overdose of prescription opioids.
QUESTION 9 FACTS IN NUMBERS: Drug War
Which of the following has had a higher death toll?
The correct answer is opioid overdose death
The total number of opioid-related deaths in the United States (>100,000) between 1999 and 2010 far exceeds the number of US military casualties in the Vietnam War (58,000) between 1965 and 1975.
- Franklin GM. American Academy of Neurology. Opioids for chronic noncancer pain: a position paper of the American Academy of Neurology. Neurology. 2014;83(14):1277-1284.