Eliminating the need for opioids in surgical procedures

Posted November 12, 2018 by Thomas Mark, M.D. Chair, Department of Anesthesia Summa Health

It is no secret that there is an opioid epidemic in the United States. Every day, more than 115 people die after overdosing on opioids. At least 20 percent of patients that visit a physician for pain symptoms will receive a prescription for an opioid.

At Summa Health, we’re forging the movement to eliminate the need for opioids in our pre-surgery, post-surgery and pain management treatments. And it is working! Not only are patients healing quicker, their overall satisfaction with their treatment is more than triple those who were prescribed an opioid. Before we get into our success rates, let’s look at the history and side effects of narcotics.

At the ‘narcotic for pain treatment boom’ in 2012, the CDC estimates that health care providers wrote 259 million prescriptions for opioid/narcotic pain medication in just that year. In 2015, more than 33,000 Americans died as a result of an opioid overdose, which included prescription opioids, heroin, and fentanyl, one of the most powerful synthetic opioids.

Our biggest loyalty should always be to the patient and here at Summa, we’re pioneering an opioid-free pain management approach. Not only does this help prevent the possibility of opioid addiction, our patients are reporting a much happier, healthier recovery process without the use of narcotics.

Narcotics have very strong, unpleasant side effects, including: constipation, nausea, vomiting and drowsiness. What you may not know about opioids is they actually make the recovery time last longer. Narcotics mostly put the patient to sleep and eliminate pain but also suppress the immune system, leading to a longer road to recovery.

How we are eliminating the need for opioids as much as possible:

• Regional blocks with local anesthetic can last for 24-36 hours. There are currently 15 different types of blocks that can assist with a variety of procedures. The side effects are relatively minimal and most patients begin recovery shortly after they wear off. At Summa, these are now being used in almost 50 percent of all procedures.
• For those who need pain control for +24 hours, a continuous peripheral nerve block can be used to continuously deliver pain medication directly to an affected area of the body. Most surgeons place the catheter before general anesthesia wears off. Not only does the catheter deliver targeted pain medication, it also significantly reduces postoperative pain, eliminates the need for pain pills and their side effects and provides a better environment for rest and recovery.
• A multi-model pain plan combines the options above with other over-the-counter pain relievers, therapy and a multifaceted approach to pain management that does not include any form of opioids.

What we are seeing:

• In January 2017, we were using narcotics in 98 percent of procedures. Now, we are at only 43 percent. Our overall, total narcotics use is down more than 90 percent.
• Patient satisfaction has grown tremendously. Our patient satisfaction has gone from a low 10th percentile to almost 93 - that’s unprecedented.
• Patients are returning home much earlier as length of stays are shortening due to quicker recovery times.
• Our readmission rate is at one of the lowest levels ever - only 8 percent.

Our goal is to get to 90 percent opioid-free procedures at Summa. Ohio is among the top five states with the highest rates of opioid-related overdose deaths and with these success stories and data, we’re more committed than ever to fight the opioid crisis in the US.

Summa Health is one of the largest integrated healthcare delivery systems in Ohio. Encompassing a network of hospitals, community health centers, a health plan, a physician-hospital organization, a multi-specialty physician organization, research and the Summa Health Foundation, we are nationally renowned for excellence in patient care and for exceptional approaches to healthcare delivery.

Summa Health also offers help for opioid or alcohol dependence. To learn more, or to enroll in the Vivitrol® Clinic, contact us at 330.379.9836.