“Today, we are in the midst of an opioid crisis,” said David Ring, MD, PhD, chair of the American Academy of Orthopaedic Surgeons Committee on Patient Safety. According to the U.S. Department of Health and Human Services, an estimated 12.5 million Americans misused prescription opioids in 2015, and approximately 15,281 overdose deaths were attributed to commonly prescribed opioids.
“Orthopaedic surgeons, along with other physicians and health care professionals, are working diligently and collectively to reduce the strength and number of opioid pills prescribed for patients, and to change the patient-doctor conversation regarding pain: how pain can be safely managed with non-opioid medications, therapies and coping strategies; and the potential danger for opioid misuse.”
The AAOS offers tips for safely managing pain and disposing of pain medications when they are no longer needed:
- First, after surgery or an injury expect some pain. Pain is part of the normal healing process and will improve day-by-day. Give your body time to heal. The first few days are typically the worst.
- Discuss a pain relief plan with your doctor and stick to it. Your doctor can specify an appropriate plan to relieve pain, which may include a combination of opioids and over-the-counter pain medications. Your doctor also can teach you warning signs to look for and how to get in touch with your medical team if you have questions or concerns. When you know that all is well, you can settle into your recovery.
- Opioids are best limited to the first few hours or days immediately following an injury or surgery. If prescribed opioids after surgery or an injury, take as few as you can and stop taking them as soon as possible. Non-opioid pain medications (such as acetaminophen or ibuprofen, or staggering of each) and other strategies may be appropriate and helpful in managing pain and ensuring comfort. For minor injuries, such as cuts or fractures, alternatives may include splints and/or regular use of ice or heat on and off the affected site. If you have new or unusual pain, contact your doctor.
- Don’t discount the power of effective coping strategies, peace of mind and relaxation on your comfort and recovery. Studies have shown that patients who are prepared for the pain of an injury or surgery feel less pain. When you remember that injury and surgery hurt, you have a more positive feeling that recovery is on track. This feeling is a great pain reliever. The support of family and friends, and the distractions of entertainment and laughter can also help you be more comfortable.
- Only take opioids as prescribed.
- Never take more than instructed, or someone else’s medication.
- Never combine opioids with alcohol or anxiety medication.
- Never use opioids for something other than pain. Opioids are not for anxiety, sleep, or fear. If you find yourself tempted to take opioids to feel happy or relaxed you are in danger.
- Always store and dispose of opioids safely.
- Pain relievers are a leading cause of serious poisoning of children and pets. Always hide or lock away prescription pain medications.
- Keep prescription medications in their original packaging so it is clear for whom the medications were prescribed and the directions for appropriate use.
- Place unused opioids in a disposal unit in a pharmacy or police station. To find a disposal site near you, visit: deadiversion.usdoj.gov/pubdispsearch.
- If no medicine take-back program is available in your area, you can flush them down the toilet, or follow simple steps to safely dispose of them in the trash. This can include mixing the medication with kitty litter or coffee grounds (do not crush the tablets or capsules), and/or placing them in a container, such as a sealed plastic bag.
- Always remove the label before throwing away an empty medication bottle.
- Remember: only one doctor should prescribe opioids. As medical record systems and state databases are implemented and improved, and laws enacted, patients will not be able to get pain medications from multiple providers.
Doctor and patient safety efforts are beginning to take hold. According to a recent report, orthopaedic surgeons have dispensed 13 percent fewer opioid prescriptions over the last three years. In addition, a growing body of research is supporting the effectiveness of alternative treatments.
“But we have much work left to do,” said Dr. Ring. “Orthopaedic surgeons want patients and their families to join us in preventing opioid misuse—this month and throughout the year.”