“Making a new opioid user is now the most common complication after surgery,” Chad Brummett warns.
The U-M anesthesiologist heads the Opioid Prescribing Engagement Network (OPEN). Launched in 2016, the group aims to cut in half the amount of opioids prescribed to surgical patients.
Previous efforts to curb prescription opioid abuse “focused on chronic pain,” Brummett explains. But “the relative contribution of acute care to opioid prescriptions is growing. Primary care and chronic pain physicians have changed how they prescribe opioids, but surgical, dentistry, or emergency room physicians have not.”
According to Brummett’s data, surgeons prescribe nearly 40 percent of opioid painkillers in Michigan. Yet “between six and ten percent of surgical patients will use prescription opioids long past the time they’re needed.”
OPEN has “been incredibly successful in a short period of time,” Brummett says. “We’ve talked to over 10,000 providers in the last year. And based on those conversations we’re getting real-world data from all of them, and we’re sending out recommendations based on that data … We can show that the number of pills [prescribed] are not related to patient satisfaction.”
Funded by a $7 million, five-year grant from the U-M and the Michigan Department of Health and Human Services, OPEN also runs take-back drives for unused opioids. “We have 1.8 million surgeries in Michigan,” Brummet says. “Forty-five pills is the average [opioid] prescription. Thirty-five pills on average are left unused. That’s 62 million unused pills in Michigan alone”–just from post-surgical prescriptions.
“This is a place where the U-M is absolutely leading,” says Brummett proudly. But he adds: “It’s important not just that doctors prescribe differently, but that patients have different expectations.” Even for post-surgical pain, “opioids aren’t always the appropriate treatment.”
