Pubdate: Sun, 27 Mar 2016 Source: New York Times (NY) Copyright: 2016 The New York Times Company Contact: http://www.nytimes.com/ref/membercenter/help/lettertoeditor.html Website: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Scott Sigman Referenced: http://www.mapinc.org/drugnews/v16/n162/a06.html OPIOID USE AND ABUSE Patients and Doctors Discuss the Management of Drugs That Can Be Helpful or Harmful. To the Editor: Re "States Push to Curb Painkiller Overuse" (Business Day, March 12): As an orthopedic surgeon in Massachusetts, I applaud the efforts of my state to limit patients' excessive opioid use. Every year in this country, more than 70 million post-surgical patients receive opioids, and research shows that one in 15 will go on to long-term use, indicating that the surgical setting has become an inadvertent gateway to the overall societal epidemic. While prescribing guidelines are an important step in addressing this issue, the best way for hospitals to take immediate action is to put in place strategies to minimize preventable opioid exposure. In my experience, using a combination approach of nonopioid medications before, during and after surgery has yielded a measurable reduction in opioids, making their use the exception, not the rule, when it comes to post-surgical pain. I'm encouraged to see this strategy being put in place at leading hospitals across the country, and likewise by the fact that Massachusetts is leading the way in opioid minimization for patients. SCOTT SIGMAN North Chelmsford, Mass. The writer is a former chief of orthopedics at Lowell (Mass.) General Hospital and a consultant to Pacira Pharmaceuticals. - --- MAP posted-by: Jay Bergstrom