There is no question that the opioid epidemic is at crisis-stage in America. The crisis is ravaging communities across the US, especially in mid-western states and rural Appalachia. In 2017, over 2,000 Americans died from opioid overdoses. Many experts now feel a large number of patients become addicted to opioids because of prescriptions that they received from their physicians. A few years ago, physicians were directed to be cognizant of our patients’ pain, and to specifically address the complaints. Part of the problem is pain is a subjective symptom and cannot be measured by any test.
One area of need for pain relief utilizing opioids involved patients undergoing chest surgery, usually for lung cancer. In the past, all of these surgeries were done using an open chest method called thoracotomy. This procedure involved making a large incision around the chest and using an instrument to spread the ribs open to allow visualization of the lung. These surgeries were associated with considerable pain. 70% of these patients left the hospital with opioid prescriptions, and 15% became long-term users of the drugs.
Today, most lung surgeries can be carried out with a procedure called video assisted thoracoscopy. This procedure is akin to a laparoscopic procedure on the chest. It is associated with considerably less pain in the immediate postoperative period, as well as the weeks and months that follow.
Patients should expect less opioid prescriptions and more careful monitoring of any requests for repeated refills.