Fewer Pain Pills May Be Best Bet After Surgery

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Surgical patients can get as good or better pain relief with a fraction of the amount of opioids typically prescribed, a group of doctors reports.

In 170 gallbladder operations from January 2015 to June 2016, they found that patients left the hospital with an average of 250 milligrams of opioids in 40 pills. Within a year, patients had taken an average of 30 milligrams of opioids, sometimes along with Tylenol or ibuprofen. Their median score on a 10-point pain scale was 5.

The study, in JAMA Surgery, then followed 200 more gallbladder surgery patients who were prescribed much lower doses: 75 milligrams of opioids in 15 pills, plus Tylenol or ibuprofen as needed. Under this program, patients used an average of 20 milligrams of opioids, along with an insignificantly larger amount of Tylenol and ibuprofen. Their average pain score was still 5.

“Some people need a lot of pills, and we have to provide them, but 6 percent of our patients become chronic opioid users,” said a co-author, Dr. Michael Englesbe, a professor of surgery at the University of Michigan. “You can’t have surgery in the U.S. without being prescribed opioids. This has to change. We write too many prescriptions, and we’re trying to change that.”