Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Publication Date: April 6, 2021

Key Points

Key Points

  • Prescribing opioids has come under scrutiny due to the nationwide epidemic of opioid dependence and overdose-related deaths.
  • Data on opioids misuse includes:
    • Chronic pain patients
      • Misuse: 21% – 29%
      • Addiction: 8% – 12%
    • 10% chronic misuse after short-stay surgery
    • 40% of misuse is from diverted opioids
  • Otolaryngologists are over-represented in prescribing opioids to Medicare patients, accounting for 10% of all surgeons’ prescriptions.
  • This summary applies to patients of any age who require treatment for anticipated or reported pain within 30 days after undergoing common otolaryngologic procedures.
For the Purpose of this Guideline, the Authors Adopted the Following Definitions:
Pain An unpleasant sensory and emotional experience associated with actual or potential tissue damage and is categorized as mild, moderate, or severe.
Postoperative period The period of patient recovery up to 30 days after a surgical procedure.
Opioids A class of medications that interact with opioid receptors, have addictive potential, and are used to treat moderate-to-severe pain. They are legally available for health care providers to prescribe as synthetic opioids such as fentanyl or prescription pain relievers such as oxycodone, hydrocodone, and others.
Analgesia The absence or reduction of pain in response to stimulation that would normally be painful.
Opioid use disorder (OUD) When individuals are unable to cease or appropriately reduce opioids and their opioid use negatively impacts work, school, or social responsibilities.
Opioid diversion The transfer of prescription pain medications from the intended person to another person.

Management

Managemen...

...ion Statements 

...ainPrior to surgery, clinicians should adv...

...difying FactorsPrior to surgery, clinicians should...

...Factors for Opioid Use Disorder Prior...

...atients at Risk for OUDIn patients at risk fo...

4. Shared Decision MakingClinicians...

...herapyClinicians should develop a multimodal...

...ioid AnalgesiaClinicians should advocat...

...ibingWhen treating postoperative pain...

...nt FeedbackClinicians should instruct patients an...

...Stopping Pain MedicationsClinicians should...

...d Disposal of OpioidsClinicians shoul...

...nt of Pain Control with OpioidsClini...


...ble 2. Duration of Analgesia Use and...


...3. Risk Factors for OUDHaving trouble viewing tab...


...sks and Benefits of Analgesic Medication ClassesHa...


...le 5. Distribution in Opioid Consumpt...


Figure 1. Source of Misused Prescription Pa...


...cure Storage and Disposal of Opioids...


...Patient Education Materials on Postoperativ...


...ure 4. Opioids Guideline Key Action S...


Patient Information

...ient Information...

...nt Information Frequently Asked Questions A...


...le 6. Abbreviated List of Medicines Rec...


...ntly Asked Questions Comparing Nonopioid and...