Opioids: The dangers of re-exposure and how we can be part of the solution
Meet Brett. Heavily involved in high school sports, a shoulder injury led to surgery. And that, as it does for millions of patients each year, led to a prescription for opioids to manage the pain. With that decision, the script changed.
But not immediately. Brett recovered and moved on with his life, which included a career as a college baseball player. A second shoulder surgery would be needed, right after college. Again, opioids were prescribed as part of the recovery. Sixty tablets of oxycodone 5mg.
As Brett described it, “game over.”
Within a week, he became physically dependent on the medication. Within a month, he was addicted.
Five lost years followed—years characterized by personal and professional struggles, disappointment, and the constant drumbeat of “where will I find the next pill.”
Thankfully, Brett found his rock bottom and “stopped digging,” as he describes it, before the consequences became even more dire. He sought treatment and has now been sober for more than five years.
What stands out from Brett’s story (aside from his courage in sharing it so openly)?
The first exposure in high school. What if the care team involved in his first surgery had used Enhanced Surgical Pathways which have been validated time and again to be opioid-sparing (and which hold the potential of opioid-free surgery)? Brett never would have had the first exposure. He would not have been primed for the re-exposure years later that ultimately led to addiction.
The Healthcare System today, far too often, does not treat the first exposure(s) to opioid painkillers with the needed caution. What’s 20 or 30 or 60 pills, the System seems to say?
Even if the patient only uses a few doses, the dominos have already started to fall:
- Leftover pills remain in the medicine cabinet, a danger not only to the patient but to the family and community (over 50% of new opioid addiction begins with the use of an opioid prescribed for someone else)
- The patient has now been exposed. In the future, if a traumatic injury occurs or a second surgery where opioids would truly be necessary arises, physical dependence and addiction are that much closer.
Opioid painkillers sit among the most dangerous legal drugs currently available. They take away years, as they did to Brett. Tragically, they also take many lives. With greater adoption of Enhanced Surgical Pathways and more thoughtful opioid prescribing, we can stop the damage and pain of the Opioid Crisis.
We’ve found the depths of the Opioid Crisis. Let’s stop digging.