Nav: Home

New effort aims to prevent surgery-related opioid addiction

October 24, 2016

ANN ARBOR, Mich. -- America's opioid drug epidemic has struck hard in Michigan. But now, a team from the University of Michigan is striking back at a key factor: opioid prescriptions for patients before and after surgery.

With a new $1.4 million per year, five-year grant from the Michigan Department of Health and Human Services, and equal funding from U-M, the team today launches an initiative to help medical teams across the state care for surgical patients' pain -- without setting those patients up for new chronic opioid use, misuse and addiction.

Named the Michigan Opioid Prescribing Engagement Network, or Michigan-OPEN, the effort aims to cut in half both the amount of opioids prescribed to Michigan surgical patients, and the number of patients who still use opioids many months after surgery.

Michigan-OPEN will tap into existing networks of hundreds of doctors, nurses and hospitals across Michigan that work together to improve surgical care. It's based in the U-M Medical School and Institute for Healthcare Policy and Innovation.

The team will help members of 12 such networks understand and use best practices for pain control in their patients, including the wisest use of opioid painkillers.

"Surgeons prescribe nearly 40 percent of opioid painkillers in Michigan, but have few resources to guide them on best use of the drugs by patients before and after surgery," says Chad Brummett, M.D., one of Michigan-OPEN's three leaders and director of the Division of Pain Research in the U-M Department of Anesthesiology. "We hope that by working with surgical teams across the state, we can fill that gap for the benefit of individual patients and our state as a whole."

U-M research shows that about one in 10 people who weren't on opioid drugs before surgery become dependent on them afterward. Such dependency can lead to poor health outcomes, as well as the potential for misuse and addiction to both prescription and illegal opioids, including heroin.

Brummett, along with surgeons Michael Englesbe, M.D., and Jennifer Waljee, M.D., M.P.H., M.S., will lead a team that will collect, analyze and share information about opioid prescribing patterns in the state. That information could help not only providers, but state policymakers and insurance plans combat the opioid epidemic.

Another key Michigan-OPEN effort will help hospitals learn how to hold drug take-back events in their communities.

The most recent such take-back event happened on Saturday, Oct. 8 in Ann Arbor at Pioneer High School and collected approximately 89,500 pills. Surgery was the most commonly reported reason that people having opioids to turn in. The oldest opioid pill turned in was prescribed in 1990.

Such events can help patients with leftover drugs get them out of the house where they can put children or others at risk. The U-M team, which has held three previous such events and collected hundreds of pounds of medication for disposal, has created an online guide available for free to anyone at .

They've also created a Google Map showing all known drug take-back locations in the state, available at .

How Michigan-OPEN will work

Because opioid abuse is a widespread issue in Michigan - costing nearly $2 billion annually and with mortality accelerating faster than in other states - Michigan-OPEN will act quickly to get evidence-based information and guidance to health care teams across the state.

The Michigan-OPEN effort will put special focus on people who have Medicaid insurance, paid for by state and federal funds. Medicaid patients account for 12 percent of surgical patients in the state, but make up 30 percent of people who develop a dependence on opioids after surgery.

In addition to working to prevent addiction in patients whose first opioid experience happens with surgery, Michigan-OPEN will also focus on patients who are already on prescription opioids before they went into surgery.

For example, a recent U-M study conducted by the Michigan-OPEN team shows that such patients' care was nine percent costlier, and resulted in more complications and hospital readmissions than that of other patients of the same age, insurance status and health level.

One key factor will act in Michigan's favor: The established networks of doctors, nurses and hospitals that Michigan-OPEN will tap into. Funded by Blue Cross Blue Shield of Michigan, they are called Collaborative Quality Initiatives, or CQIs.

Until now, most CQIs have focused on standardizing surgical care, and preventing complications and errors, in the participating hospitals. Under the opioid initiative, the Michigan-OPEN team will work with each CQI to create "bundles" of tactics targeted to both patients and healthcare providers, that each hospital can use to reduce opioid prescribing and dependence.

This includes strategies geared toward not just surgeons, but also primary care and specialty physicians who care for surgical patients before and after their operations.

For example, Waljee notes that a recent survey of surgeons across Michigan conducted by the Michigan-OPEN team demonstrated that nearly half of surgeons don't talk about pain management expectations and considerations with patients they will soon operate on.

The CQIs that will take part in Michigan-OPEN in the first year include ones that focus on a broad range of surgical specialties. The data collection and analysis team for each of them is based at U-M, and led by a U-M Medical School faculty member, making coordination with the Michigan-OPEN leaders very easy.
For more about Michigan-OPEN, visit

For more about IHPI, visit

University of Michigan Health System

Related Pain Articles:

Spinal manipulation treatment for low back pain associated with modest improvement in pain, function
Among patients with acute low back pain, spinal manipulation therapy was associated with modest improvements in pain and function at up to six weeks, with temporary minor musculoskeletal harms, according to a study published by JAMA.
Pain in the neck
Researchers led by University of Utah bioengineering assistant professor Robby Bowles have discovered a way to curb chronic pain by modulating genes that reduce tissue- and cell-damaging inflammation.
Can staying active help to prevent chronic pain? Physical activity affects pain modulation in older adults
Older adults with higher levels of physical activity have pain modulation patterns that might help lower their risk of developing chronic pain, reports a study in PAINĀ®, the official publication of the International Association for the Study of Pain (IASP).
Is back pain killing us?
Older people who suffer from back pain have a 13 per cent increased risk of dying from any cause, University of Sydney research has found.
Improving pain care through implementation of the Stepped Care Model for Pain Management
A new study published in the Journal of Pain Research provides evidence that implementation of a Stepped Care Model for Pain Management has the potential to more adequately treat chronic pain.
Surgery for back pain reduces problems with sex life-related pain
For patients with degenerative spinal disease, surgery is more effective in reducing pain that interferes with sexual activity, compared to nonsurgical treatment, reports a study in the Nov.
'Pain paradox' discovery provides route to new pain control drugs
A natural substance known to activate pain in the central nervous system has been found to have the opposite effect in other parts of the body, potentially paving the way to new methods of pain control.
Treating pain without feeding addiction: Study shows promise of non-drug pain management
A new study shows the potential for patients who have both addiction issues and chronic pain to get relief from an approach that combines behavioral therapy and social support to help them manage their pain without painkillers that carry an addiction risk.
Neuropathic pain unmasks subliminal excitation in pain processing circuits
Research by Steven Prescott, at Toronto's Hospital for Sick Children, sheds new light on the mechanism underlying the establishment of neuropathic pain.
The anatomy of pain
Emotions consist of general components that are also elicited by similar impressions and specific components.

Related Pain Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Jumpstarting Creativity
Our greatest breakthroughs and triumphs have one thing in common: creativity. But how do you ignite it? And how do you rekindle it? This hour, TED speakers explore ideas on jumpstarting creativity. Guests include economist Tim Harford, producer Helen Marriage, artificial intelligence researcher Steve Engels, and behavioral scientist Marily Oppezzo.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".