Mind-body approaches for reducing the need for post-operative opioids: Evidence and opportunities

Abstract

While opioids remain our most potent analgesics in the management of pain, the many potential harms of prescription opioids have become increasingly clear. Despite the analgesic benefits for people with acute and chronic pain [1], opioid therapy (especially long-term opioid treatment) can result in significant problems such as opioid misuse, the development of opioid use disorder, and overdose. Some authors report that up to 20-30% of patients in primary and tertiary care settings who are maintained on long-term opioid therapy misuse opioids (i.e., use them in a manner other than how the opioids are prescribed) [2,3]. Misuse of opioids can cause or exacerbate additional health problems in people with chronic pain [1,4], and in fact, roughly 10% of patients prescribed long-term opioid therapy may develop an opioid use disorder (OUD), although prevalence estimates vary between studies depending on differences in methodology and operational definitions [3]. Surgery is a common point of exposure to opioids for many individuals, and recent data suggest that substantial percentages of opioid-naive patients will go on to long-term opioid use following a surgery (e.g., approximately 6% in one large national survey [5]). With over 50 million surgeries performed in the US each year [6], the periand post-operative period represents an important window of opioid-related risk for many Americans.