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In this episode, episode 74, I welcome Dr. Chad Brummett to the show. Chad is the co-director of the Opioid Prescribing Engagement Network (OPEN) in Michigan and leads some fantastic and extremely effective initiatives to combat the opioid crisis. His website has more details and materials for anyone interested in starting similar initiatives elsewhere. Check it out at Michigan-open.org.
CME: https://earnc.me/uqMyBJ
Outline by Brian Park: Opioid Crisis Engagement outline
Good work and it’s a great start but I was pretty shocked at the amount of pills prescribed. Maybe it’s helpful to look at what the rest of the world does. Unless it is major maxillary surgery I have never heard of opiates being prescribed for dental. Thyroid surgery in my experience almost never need any opiates after the peroperative dose. We rarely ever give opiates after discharge from hospital including major surgery ( spinal chronic pain excluded and to be honest I haven’t seen much good from that) . So it’s maybe 3 max 5 days in hospital then nsaid’s . Management of expectations is a large part I found: Don’t expect to not feel that you have been operated on but you shouldn’t be in any great pain.
Absolutely. I think we’ve got a ton to learn from our colleagues in other countries. Thanks!
The day after I listened to this podcast did pedi/adolescent case and in room surgeon stated to surgery resident that she would be Rx’ing 5 oxycodone tablets. I wonder if pedi/adolescent Rx’ing tends to be more appropriate as this seemed very reasonable. I am curious to see if Rx’ing in pedi literature is more in line w site referenced on episode.
I asked Dr. Brummett and he said there is some work on the pediatric population coming from his team at Michigan, as well as a couple of centers around the US. There are additional complexities, including weight-based dosing, use of liquid meds and parental oversite. There is certainly room for improvement here too. Thanks!