In This Article
- In recent years, there is strong evidence urologists have exacerbated the opioid addiction epidemic by overprescribing opioids
- Massachusetts General Hospital is focused on combating opioid over prescription by using alternative pain management methods, multidisciplinary collaboration and patient education
- Mass General surgeons use local blocks, including incisional blocking, which help reduce postoperative opioid use
- Decreasing opioid use during and after surgery reduces the risk of patient readmission
Francis J. McGovern, MD, a urologist at Massachusetts General Hospital, believes that we are currently experiencing the third opioid epidemic in America. In recent years, many urologists prescribing opioids for pain management have actually exacerbated the opioid addiction epidemic. They often overprescribe narcotics after surgery, and most patients receive no instructions for safely disposing of excess pills.
Overuse of opioids intraoperatively and postoperatively potentially creates a hyperalgesia-like syndrome, making patients more sensitive to pain weeks after surgery. Decreasing opioid use during and after surgery reduces the risk of readmission.
To combat opioid overprescription, Mass General emphasizes alternative pain management methods, multidisciplinary collaboration and patient education, according to Dr. McGovern. By collaborating with anesthesia colleagues, urologists could use blocks such as regional or local anesthetics during and after surgery.
In his own practice, Dr. Govern is using preemptive non-opioid medications, such as giving rectus sheath blocks and numbing the rectus abdominis, which has led to a low readmission rate of under 1%.
Dr. McGovern informs patients that he is prescribing them opioids for acute pain if needed, but by educating them about what to expect and the potential risks of opioid use, many choose not to use the drugs. Along with educating his patients, he and his colleagues teach floor staff, nurses, nurse practitioners and physicians to reduce opioid use, which reduced prescriptions by 75%.
Learn more about the Massachusetts General Physicians Organization (MGPO) Opioid Task Force
Refer a patient to the Department of Urology