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Roswell Park Sheds Light on Handling the Opioid Crisis

Roswell Park Comprehensive Cancer Center has determined what most of us could have predicted pertaining to the rampant over prescribing of opioids – “New research from Roswell Park Comprehensive Cancer Center suggests that medical care providers are able to significantly reduce use of opioid painkillers through a two-step process: providing fewer opioids to patients upon their discharge following surgery, and supporting good communication between the clinical team and the patient.”

Now, this sounds like a completely new direction from the same senseless tack that doctors have been heading for years. MDs have been over prescribing opioids for myriad reasons – from making a quick buck, to the ease of prescribing without thinking about the repercussions.

These new clinical results show that over prescribing addictive painkillers is not the answer – restrictive approaches to pain management is the new reasoning. 

In addition to these restrictive approaches, there must be further crackdowns on opioid manufacturers and distributors in order to disrupt online sales of illicit opioids. The Roswell Park study will also help in regulating doctors from needlessly prescribing and distributing opioids and other narcotics. Finally, there must be additional disruption of illegal overseas fentanyl (for example) manufacturers and importers.

Emese Zsiros

Roswell Park’s findings were presented during  a plenary session at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. The research, led by Emese Zsiros, MD, PhD, FACOG, Assistant Professor of Oncology with the Department of Gynecologic Oncology and Center for Immunotherapy, occurred during a 19-month study in patients undergoing major gynecologic surgeries. Patients with ambulatory or minimally invasive surgery (who did not have a history of chronic pain) were not issued opioids upon discharge, while patients undergoing open surgery were given three day supplies of opioids, rather than the typical seven day supply. The reduction led to an incredible 89% reduction of prescriptions – from 31.7 to 3.5 opioid tablets, on average, overall among all patients and by 97%, from 28.1 to .9 tablets, on average, in patients whose surgeries were minimally invasive or ambulatory, meaning no inpatient admission was required.

The numbers of patients requesting opioid refills within 30 days of surgery decreased, and even those patients with a history of chronic pain saw their need for opioids reduced by 83% compared to the control group.

Jaron Mark

“We were quite surprised by how few inquiries and requests for medication we got from our patients,” says Jaron Mark, MD, a clinical fellow at Roswell Park who presented the research at SGO today. “We expected that we’d be able to reduce use of opioids without detrimental consequences, but the extent to which our hypothesis was supported by these results was really striking.”

By issuing fewer prescriptions, and limiting prescription amounts, the rampant opioid addiction scourge should be greatly impacted. It’s also important to ensure that unused circulating opioid pills are not accessible to those at risk, according to the researchers.

“I think the key to our experience here was setting expectations about pain management in advance — with both the clinical team and with our patients,” adds Dr. Zsiros. “It actually might take a little more time and effort by the clinical team to prescribe fewer doses of pain medication, but our results show that those efforts are well worth it in terms of reducing the likelihood of long-term opioid dependence or abuse.”

Written by Buffalo Rising

Buffalo Rising

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