According to a study, Canadians are much more likely to fill their opioid prescription after routine surgery than Swedish patients

Canadians are much more likely than Swedish patients to submit to a prescription for opioid analgesics after routine surgery, suggesting that powerful narcotics are still distributed too liberally despite requests for change.

A new study published Wednesday in the journal JAMA Network Open revealed that about 79% of Canadian patients and 76% of American counterparts had prescribed an opioid prescription within seven days of routine surgery, compared with only 11% of patients Sweden. Patients have all undergone one of the following four minor procedures: laparoscopic surgery to remove the appendix or gall bladder, arthroscopic or keyhole surgery to remove the meniscus from the knee and surgery to remove a size at the knee. breast.

"We often think that opioids are the best painkillers for the treatment of acute pain," said Karim Ladha, one of the study's authors and anesthesiologist at St. Michael's Hospital in Toronto. "In other countries, they do not even bother to go there."

Canada is currently going through an opioid overdose crisis: 12 people are dying every day as a result of drugs. Illicit fentanyl is to blame for the vast majority of deaths. But prescription opioids still play an important role in the problem and expose people to the risk of addiction, dependence and abuse.

New national guidelines were published in 2017 to help clinicians navigate prescription opioids for patients with chronic pain, but there are no similar national guidelines for acute pain. Recent research has highlighted the risks of prescribing opioids for the treatment of acute pain and a growing number of experts are drawing attention to this problem.

Dr. Ladha said that his wife's experience after a caesarean section was one of the reasons he conducted this study. Although she did not require an opioid analgesic while in hospital, Dr. Ladha's wife was discharged with a 30-day narcotic analgesic prescription.

He said it was time for patients and clinicians to think about treatment and pain management. For too long, the goal seemed to be to ensure that patients remain pain free at all times, said Dr. Ladha, but this state of mind exposes them to risks of drug dependence. opioids and other problems.

"We need to define the pain expectations after surgery and we really need to prescribe in a way that is tailored to the needs of patients," he said.

Anita Srivastava, Assistant Professor in the Department of Family and Community Medicine at the University of Toronto, echoed these comments, saying that opioids should not be the default prescription, especially given the risks they pose.

"I think the idea that we are automatically getting a prescription for pain or that there will be no pain after an intervention needs to be changed," she said.

The study found that American patients were more likely to receive higher doses of opioids than those in Canada. But the study found that Canadians were more likely than Americans to be prescribed codeine and tramadol. Some opioid addiction experts say that these drugs are often misunderstood as safer opioids, which could explain why they are so frequently prescribed after minor surgery.

The study period in Canada ran from July 2013 to March 2016. Prescription rates may have decreased since then, but Dr. Srivastava said the trends were probably very similar today.

"I think there will always be a big gap between us and Sweden," she said.

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