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Thwarting the Opiate Crisis: Emerging Recommendations to Reduce Opiate Abuse

Nathan, Naveen MD

doi: 10.1213/ANE.0000000000004311
Infographics: Infographic
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Northwestern University Feinberg School of Medicine (n-nathan@northwestern.edu).

Published ahead of print 23 May 2019.

The Infographic is composed by Naveen Nathan, MD, Northwestern University Feinberg School of Medicine (n-nathan@northwestern.edu). Illustration by Naveen Nathan, MD.

The author declares no conflicts of interest.

The characterization and prospective management of perioperative analgesia in the context of the opiate crisis are just beginning to take shape. An important initial observation is that there exists no agreed upon definition of persistent postoperative opiate use. This infographic summarizes the consensus statement from the American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) on identifying this condition. This largely involves an assessment of prescription refills over a defined period of time after discharge. In addition, a panel of international experts through ASER and the POQI offers their recommendations on perioperative minimization of opiate use that includes opiate-sparing anesthesia, multimodal analgesia, reduction in opiate prescriptions on discharge, and the use of a pain specialist for guidance. For the complete consensus recommendations, the reader is referred to the cited articles herein.

ASER indicates American Society for Enhanced Recovery; POQI, Perioperative Quality Initiative.

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REFERENCES

1. Kent ML, Hurley RW, Oderda GM, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative-4 joint consensus statement on persistent postoperative opioid use: definition, incidence, risk factors, and health care system initiatives. Anesth Analg. 2019;129:543552.
    2. Anderson TA, Ahmad S. Defining and reducing the risk of persistent postoperative opioid use. Anesth Analg. 2019;129:324326.
      3. Wu CL, King AB, Geiger TM, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on perioperative opioid minimization in opioid-naïve patients. Anesth Analg. 2019;129:567577.
        4. Edwards DA, Hedrick TL, Jayaram J, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative joint consensus statement on perioperative management of patients on preoperative opioid therapy. Anesth Analg. 2019;129:553566.
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