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Review
. 2018 Jul 3:7:16.
doi: 10.1186/s13741-018-0097-4. eCollection 2018.

The rising tide of opioid use and abuse: the role of the anesthesiologist

Elena J Koepke  1 , Erin L Manning  2 , Timothy E Miller  1 , Arun Ganesh  3 , David G A Williams  1 , Michael W Manning  1
Affiliations
Review

The rising tide of opioid use and abuse: the role of the anesthesiologist

Elena J Koepke et al. Perioper Med (Lond). .

Abstract

Opioid use has risen dramatically in the past three decades. In the USA, opioid overdose has become a leading cause of unintentional death, surpassing motor vehicle accidents. A patient's first exposure to opioids may be during the perioperative period, a time where anesthesiologists have a significant role in pain management. Almost all patients in the USA receive opioids during a surgical encounter. Opioids have many undesirable side effects, including potential for misuse, or opioid use disorder. Anesthesiologists and surgeons employ several methods to decrease unnecessary opioid use, opioid-related adverse events, and side effects in the perioperative period. Multimodal analgesia, enhanced recovery pathways, and regional anesthesia are key tools as we work towards optimal opioid stewardship and the ideal of effective analgesia without undesirable sequelae.

Keywords: Enhanced recovery pathways; Multimodal analgesia; Opioid epidemic; Opioid-free anesthesia; Opioid-reduced anesthesia; Perioperative medicine.

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Conflict of interest statement

Not applicableNot applicableThe authors declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Rates of opioid pain reliever overdose death, opioid pain relief treatment admissions, and kilograms of opioid pain relievers sold—United States, 1999–2010. Age-adjusted rates per 100,000 population for opioid pain reliever (OPR) deaths, crude rates per 10,000 population for OPR abuse treatment admissions, and crude rates per 10,000 population for kilograms of OPR sold. From Centers for Disease Control and Prevention (2011)
Fig. 2
Fig. 2
New paradigm in analgesia management. The old way of management of pain has relied on opioids as the foundation of pain control, with non-opioid adjuncts added if necessary due to patient condition. In the new way, management of pain begins with non-opioid-based techniques that are evidence based and demonstrated to decrease opioid use
See this image and copyright information in PMC

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