Editorial  |   June 2020
Persistent Postoperative Opioid Use: Perception, Progress, and Promise
Author Notes
  • From the Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina (E.D.K.); Anesthesiology, Schaumburg, Illinois (E.D.K.); Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California (J.D.C.); and Department of Anesthesiology, Stanford University School of Medicine, Stanford, California (J.D.C.).
  • This editorial accompanies the article on p. 1528.
    This editorial accompanies the article on p. 1528.×
  • Michael M. Todd, M.D., served as Handling Editor for this article.
    Michael M. Todd, M.D., served as Handling Editor for this article.×
  • Accepted for publication March 9, 2020. Published online first on March 31, 2020.
    Accepted for publication March 9, 2020. Published online first on March 31, 2020.×
  • Address correspondence to Dr. Kharasch: evan.kharasch@duke.edu
Article Information
Editorial
Editorial   |   June 2020
Persistent Postoperative Opioid Use: Perception, Progress, and Promise
Anesthesiology 6 2020, Vol.132, 1304-1306. doi:https://doi.org/10.1097/ALN.0000000000003298
Anesthesiology 6 2020, Vol.132, 1304-1306. doi:https://doi.org/10.1097/ALN.0000000000003298
The opioid crisis, related to widespread inappropriate oral opioid prescribing and attendant problems with misuse, diversion, addiction, and overdose deaths, continues to influence anesthesia and surgical practice. The influences are external, such as federal guidelines, state laws, and restrictions by pharmacies, insurers, and healthcare institutions, but are also overtly self-imposed and subconsciously altered behaviors and practices of practitioners regarding opioid use and prescribing.
In addressing opioid use, there is often failure to distinguish between intraoperative opioid use, immediate postoperative opioid prescribing, and convalescent opioid use, and their benefits and risks.1  While all aspects of opioid use are being appropriately scrutinized, one target receiving considerable attention is postoperative-postdischarge opioids. Prescribing of postsurgical oral take-home opioids at discharge, typically by surgeons, has been recognized as often excessive, creating a reservoir of unused opioids available for diversion and misuse, and this Journal previously called for postdischarge prescribing habits to change.2  These changes have occurred coincident with or caused by practitioner awareness, federal guidelines, state prescribing laws, and restrictions by pharmacies, insurers, and healthcare institutions.