Targets to eliminate pain after surgery are a major cause of the opioid crisis in several countries, according to a major new report.
Published in The Lancet, the report, which is co-authored by Professor Lesley Colvin of the University of Dundee, brings together global evidence detailing the role of surgery in the opioid crisis.
The authors conclude that pain management has been a substantial contributor to the crisis due to inappropriate prescribing of opioids. Chronic post-surgical pain is a growing problem as the population ages and more operations are carried out.
It can occur after any type of surgery.
- READ MORE: Opioid prescriptions highest in poorest areas - study finds links with obesity and smoking
Each year, 320 million people had surgery and chronic pain occurs in 10 per cent of cases.
The use of prescription opioids worldwide more than doubled between 2001-2013 – from 3 billion to 7.3bn daily doses per year – and doctors in many countries worldwide give medication in excess of what is needed for pain control, increasing the risks of misuse.
The authors have called for interventions including specialist pain clinics, drug monitoring policies and new pain management methods, including the use of alternative pain relief medication, to curb the crisis.
“Most people are aware of the opioid epidemic in the States, where there’s been a huge increase in strong opioids prescribed for the management of chronic pain,” said Prof Colvin, Chair of Pain Medicine at Dundee University’s School of Medicine.
“One of the things we’re trying to do is find out why that’s happened. “There’s no doubt that one of the contributors has been people having surgery. “They need strong painkillers afterwards and those painkillers are sometimes not stopped when they should be.”
Prof Colvin said a key aim was reducing the incidence of opioid misuse.
“People carry on, sometimes with chronic pain, but they carry on with bigger doses of opioids so they end up with the problems of the side effects, misuse problems, tolerance and opioid-induced hyperalgesia,” she added.
“Better understanding of the effects of opioids at neurobiological, clinical, and societal levels is required to improve future patient care. There are research gaps that must be addressed to improve the current opioid situation. Firstly, we must better understand opioid tolerance and opioid-induced hyperalgesia to develop pain relief treatments that work in these conditions.
“We also need large populationbased studies to help better understand the link between opioid use during surgery and chronic pain.”
Why are you making commenting on The Herald only available to subscribers?
It should have been a safe space for informed debate, somewhere for readers to discuss issues around the biggest stories of the day, but all too often the below the line comments on most websites have become bogged down by off-topic discussions and abuse.
heraldscotland.com is tackling this problem by allowing only subscribers to comment.
We are doing this to improve the experience for our loyal readers and we believe it will reduce the ability of trolls and troublemakers, who occasionally find their way onto our site, to abuse our journalists and readers. We also hope it will help the comments section fulfil its promise as a part of Scotland's conversation with itself.
We are lucky at The Herald. We are read by an informed, educated readership who can add their knowledge and insights to our stories.
That is invaluable.
We are making the subscriber-only change to support our valued readers, who tell us they don't want the site cluttered up with irrelevant comments, untruths and abuse.
In the past, the journalist’s job was to collect and distribute information to the audience. Technology means that readers can shape a discussion. We look forward to hearing from you on heraldscotland.com
Comments & Moderation
Readers’ comments: You are personally liable for the content of any comments you upload to this website, so please act responsibly. We do not pre-moderate or monitor readers’ comments appearing on our websites, but we do post-moderate in response to complaints we receive or otherwise when a potential problem comes to our attention. You can make a complaint by using the ‘report this post’ link . We may then apply our discretion under the user terms to amend or delete comments.
Post moderation is undertaken full-time 9am-6pm on weekdays, and on a part-time basis outwith those hours.
Read the rules here