Expert Panel Recommends Limiting Opioid Prescribing Based on Type of Operation

An expert panel of health care providers and patients are recommending that opioid prescribing limits should be based on the operation performed rather than a blanket approach. The ranges offered for each of 20 common operations generally call for reductions from the current rates of opioid prescription, and the researchers note that patients themselves favor using less of the medications than often prescribed.

In a recently published paper, the researchers, from Johns Hopkins University School of Medicine, explain the process of consensus reached by 30 surgeons, pain

specialists, outpatient surgical nurse practitioners, surgical residents, patients and pharmacists.

“Prescriptions for pain meds after surgery should be custom tailored to the operation and a patient’s needs and goals, but the hope is that these guidelines will help reset ‘defaults’ that have been dangerously high for too long,” Martin Makary, MD, MPH, a professor of surgery and health policy expert at the Johns Hopkins University School of Medicine and the study’s senior author said in a press release.

The guidelines are already being used to educate Johns Hopkins residents and surgeons and to replace the current e-prescribing defaults that appear in prescribing systems. A second expert panel of dentists has also duplicated the effort for dental procedures.

Johns Hopkins researchers recognized the need for creating a consensus around guidelines for appropriate amounts of opioids. In efforts to develop such detailed guidelines, Makary and his colleagues convened 30 health care professionals from the Johns Hopkins Health System, split into 6 groups: surgeons, pain specialists, outpatient surgical nurse practitioners, surgical residents, patients, and pharmacists. Makary provided each panel member with relevant literature on addiction and other risks of opioids.