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Addressing Excess Opioids in Ob/Gyn Care

Op-Med is a collection of original articles contributed by Doximity members.

Dr. Amanda Williams is a 2020–2021 Doximity Research Review Fellow. Nothing in this article is intended nor implied to constitute professional medical advice or endorsement. The views expressed in this article are those of the author and do not necessarily reflect the views/position of Doximity. 

Surgeons have an important role to play in combating the opioid epidemic. Many postoperative patients are sent home with an excess of opioids. The result — unused pills sitting at home, often unlocked and undisposed — creates risk for other people in the household. Awareness of this issue has resulted in a continued shift toward Enhanced Recovery After Surgery (ERAS), and research into how much medicine we should prescribe our patients in order to relieve their pain without creating danger. 

Recently, gynecologic surgeons at New York University were able to safely and significantly decrease the number of postoperative patients going home with an opioid prescription, as well as the average number of opioid tablets prescribed per patient, without creating an increase in postoperative calls or in patients requiring an opioid refill. This held true for patients undergoing either minimally invasive surgery or laparotomy. Their report outlines their protocols and prescribing practices. The specific algorithms designed for restrictive opioid prescription, as well as the recommendations regarding patient education and multidisciplinary buy-in within institutions, can reasonably be used elsewhere to work toward similar achievements. 

Dr. Williams completed her undergraduate training at the University of Notre Dame in 2013 after majoring in physics. She then went on to medical school in Chicago and is now in her final year of ob/gyn residency in Houston, Texas.

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