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Review
. 2017 Oct;140(4):613e-619e.
doi: 10.1097/PRS.0000000000003742.

Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

Daniel Demsey  1   2 , Nicholas J Carr  1   2 , Hance Clarke  1   2 , Sharon Vipler  1   2
Affiliations
Review

Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

Daniel Demsey et al. Plast Reconstr Surg. 2017 Oct.

Abstract

Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder. This review gives an update of the current state of the opioid crisis, explains how current surgeons' prescribing practices are contributing to it, and gives recommendations on how to use opioid medication safely in the perioperative period.

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Figures

Fig. 1
Fig. 1
National overdose deaths (number of deaths from opioid drugs). The figure above is a bar chart showing the total number of U.S. overdose deaths involving opioid drugs from 2002 to 2015. Included in this number are opioid analgesics, along with heroin and illicit synthetic opioids. (From the CDC Wonder.)
Fig. 2
Fig. 2
Opioid Risk Tool. Rx, prescription; ADD, attention deficit hyperactivity disorder; OCD, obsessive-compulsive disorder. (From Webster LR, Webster R. Predicting aberrant behaviors in opioid treated patients: Preliminary validation of the Opioid Risk Tool. Pain Med. 2005;6:432–442.)
Fig. 3
Fig. 3
Summary of recommendations. NSAIDs, nonsteroidal antiinflammatory drugs; TAP, transversus abdominis plane.
See this image and copyright information in PMC

References

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MeSH terms

Substances