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Managing Opioid Addiction Risk in Plastic Surgery during the Perioperative Period

Demsey, Daniel, M.D., M.A.Sc.; Carr, Nicholas J., M.D.; Clarke, Hance, M.D., Ph.D.; Vipler, Sharon, M.D.

Plastic and Reconstructive Surgery: October 2017 - Volume 140 - Issue 4 - p 613e-619e
doi: 10.1097/PRS.0000000000003742
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Summary: Opioid addiction is a public health crisis that affects all areas of medicine. Large numbers of the population across all racial and economic demographics misuse prescription opioids and use illicit opioids. The current understanding is that opioid misuse is a disease that requires treatment, and is not an issue of choice or character. Use of opioid medication is a necessary part of postoperative analgesia, but many physicians are unsure of how to do this safely given the risk of patients developing an opioid misuse disorder. This review gives an update of the current state of the opioid crisis, explains how current surgeons’ prescribing practices are contributing to it, and gives recommendations on how to use opioid medication safely in the perioperative period.

Vancouver, British Columbia; and Toronto, Ontario, Canada

From the Division of Plastic Surgery and the Fraser Health Substance Use Services, University of British Columbia; and the Department of Anaesthesia and Pain Management, University of Toronto, Toronto General Hospital.

Received for publication January 9, 2017; accepted March 28, 2017.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Daniel Demsey, M.D., M.A.Sc., Vancouver General Hospital, 2nd. Floor, Jim Pattison Pavilion South, 855 West 12th Avenue, Vancouver, British Columbia V5Z 1M9, Canada, daniel.demsey@gmail.com

Copyright © 2017 by the American Society of Plastic Surgeons