Michigan Tackles Opioid Problem Head-On

A team from the University of Michigan (U-M) is being very proactive regarding the opioid epidemic. Armed with a new $1.4 million per year, five-year grant from the Michigan Department of Health and Human Services, and equal funding from U-M, the researchers have created the Michigan Opioid Prescribing Engagement Network, or Michigan-OPEN.

This initiative, says the October 24, 2016 news release, will “help medical teams across the state care for surgical patients’ pain—without setting those patients up for new chronic opioid use, misuse and addiction…Michigan-OPEN aims to cut in half both the amount of opioids prescribed to Michigan surgical patients, and the number of patients who still use opioids many months after surgery…Another key Michigan-OPEN effort will help hospitals learn how to hold drug take-back events in their communities.”

“Surgeons prescribe nearly 40% of opioid painkillers in Michigan, but have few resources to guide them on best use of the drugs by patients before and after surgery, ” says Chad Brummett, M.D., one of Michigan-OPEN’s three leaders and director of the Division of Pain Research in the U-M Department of Anesthesiology. “We hope that by working with surgical teams across the state, we can fill that gap for the benefit of individual patients and our state as a whole.”

Dr. Brummett told OTW, “Opioid misuse and abuse is a national epidemic, and most of the ongoing efforts to address the issues focus on the treatment of chronic pain and opioid abusers. Despite the fact that surgeons prescribe ~40% of the opioids in the United States, there are no guidelines to inform postoperative prescribing. Our group has data to suggest that ~6% of people not taking opioids before surgery become new chronic users, even after minor surgeries. For some surgeries, the rates appear to be higher. We believe that this is an adverse outcome and should be prevented. Moreover, we currently greatly overprescribe opioids after surgery, and many of these pills go unused and can become source of misuse and abuse.”

“Assuming about 53 million surgeries per year in the United States, our data suggest that surgery may create 2.5 million new chronic opioid users each year, even after accounting for those previously using opioids. Our aim is the keep this effort patient-centered by appropriately treating postoperative pain but also helping patients stop opioids after their recovery from surgery. Furthermore, we believe surgeons must be involved in the process, as this is an iatrogenic problem.”

“We hope to provide the data needed to inform appropriate postoperative prescribing after surgery. Multiple studies indicate that we prescribe far in excess of what patients use, and it is critical that we work together to fix this public health crisis.”