Johns Hopkins Surgery Prof: 'I Gave Out Opioids Like Candy'

For most of my surgical career, I gave out opioids like candy. My colleagues and I were unaware that about 1 in 16 patients become chronic users, according to new research by doctors at the University of Michigan. Even more alarming, research shows that relapse rates after opioid addiction treatment could be as high as 91 percent. In addition to expanding treatment, it’s time we address the root of the problem — overprescribing.

My own aha moment came recently after my father had gallbladder surgery and recovered comfortably at home with a single ibuprofen tablet. Wow. It directly contradicted my residency training 15 years ago, when I was taught to give every surgical patient a prescription for 30-90 opioid tablets upon discharge. Some of my mentors told me that overprescribing prevents late night phone calls asking for more. The medical community at that time ingrained in all of us that opioids were not addictive and urged liberal prescribing. So that’s exactly what we did.

Too many Americans are leaving the hospital with bottles full of opioid tablets they don’t need.

We need to take away the matches, not put out the fires.

My colleagues at Johns Hopkins and I have used data to identify the average number of opioids a doctor prescribes after a routine C-section, excluding patients with pre-existing opioid use or pain syndromes. The range is stunning. Some doctors fall within what Johns Hopkins specialists call “best practices range,” averaging three to 10 opioid tablets after C-section. Others still average 30 or 60 tablets.

Purdue even gave out free samples, a curious gesture if you truly believe your product is non-addictive. Using a patient starter coupon, the first dosing was free. By 2001, about 34,000 coupons had been redeemed. By marketing directly to the consumer, Purdue knew that after the first taste — the free taste — many would come back to their doctors demanding another prescription for OxyContin, which is exactly what happened.