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London, Ont. researchers develop protocol to drastically reduce opioid prescriptions

Prescription pills containing oxycodone and acetaminophen are shown in Toronto, Dec. 23, 2017.
Prescription pills containing oxycodone and acetaminophen are shown in Toronto, Dec. 23, 2017. THE CANADIAN PRESS/Graeme Roy

As North America battles an opioid epidemic, a team of researchers out of Lawson Health Research Institute and Western University has developed a plan aimed at preventing addiction in the first place.

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“They’re good for pain control, but when used responsibly,” stressed author Dr. Luke Hartford.

“What we were focusing on, is not the message that opioids are bad medications but just that we’re prescribing excessive amounts.”

As part of the protocol, the Standardization of Outpatient Procedure (STOP) Narcotics, doctors tell patients leaving hospital after surgery to take around-the-clock Tylenol and anti-inflammatory medication that they prescribe, and then give them a prescription for a limited amount of opioids that expires in a week.

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The study showed that those given the STOP Narcotics protocol were 50 per cent less likely to be prescribed opioids in the first place, and those who were still prescribed opioids were 45 per cent less likely to fill the prescription than in a control group.

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“I think one of the big things to come out of this, is patients start to use non-opioid analgesic like Tylenol and anti-inflammatories around the clock which they weren’t doing before because they might not have known how effective they are,” author Dr. Patrick Murphy told 980 CFPL.

“With that increase in non-narcotic medication, the narcotic use and even filling of the prescription dropped drastically.”

Dr. Julie Vankoughnett added that she believes the success of the study is down to its multi-pronged approach.

“We really focused on educating patients before surgery about the different options that are available to them and encouraged them to only use their opioid if the other methods didn’t work,” she explained.

“We also really educated the doctors, the anesthesia doctors, the nurses, and our resident doctors who are training to be surgeons, in addition to the patient, so that we were all on the same page.”

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The study involved 416 patients at London Health Sciences Centre (LHSC) and St. Joseph’s Health Care London who underwent laparoscopic cholecystectomy or open hernia repair and is being presented Wednesday at the American College of Surgeons Clinical Congress. It’s also published in the Journal of the American College of Surgeons.