Slauterbeck: New research supports prescribing fewer opioids after surgery

Opioid addiction remains a major public health crisis in the United States, with post-surgical prescriptions often playing a significant role.

For years, high doses of opioids were routinely prescribed for pain relief after surgery, but their use has been linked to serious cognitive impairments, including sedation, delirium, mood changes, and addiction, as well as severe physical risks such as respiratory depression, impaired motor function, delayed recovery, and the development of tolerance and withdrawal symptoms.

In response, a growing body of research is encouraging orthopedic surgeons to adopt safer, more effective pain management strategies that reduce reliance on opioids while ensuring optimal patient recovery.

Instead of relying on opioids, many physicians are now turning to a multimodal approach that includes scheduled doses of acetaminophen (Tylenol) and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.

Ibuprofen’s anti-inflammatory properties help reduce swelling and pain, while acetaminophen enhances overall pain control. When used together, these medications provide a potent, non-addictive alternative for managing post-surgical discomfort.

A recent study published in The Journal of Bone and Joint Surgery (2024) reinforces this shift.

Researchers at the Rothman Orthopedic Institute examined 180 patients who underwent anterior cruciate ligament (ACL) reconstruction, a common outpatient sports medicine procedure.

Patients were prescribed varying amounts of oxycodone 15, 25, or 35 tablets and their pain levels, opioid consumption, and overall satisfaction were monitored.

The findings were striking. Patients who received fewer opioids experienced the same level of pain relief, functional recovery, and satisfaction as those who were prescribed more.

Notably, 72 percent of all opioids were consumed within the first three days, and 83 percent of patients in the 15-pill tablet group reported having an adequate or even excessive supply of medication.

This research underscores the growing evidence that post-surgical opioid prescriptions can be safely reduced without compromising pain control.

By prioritizing non-opioid pain management strategies such as acetaminophen, NSAIDs, transcutaneous electrical nerve stimulation (TENS) units, and physical therapy, surgeons can help patients recover comfortably while minimizing the risks of addiction and misuse.

As the medical community continues to refine best practices for post-surgical pain management, studies like this provide compelling support for a more cautious and responsible approach to opioid prescribing.

The shift toward non-opioid alternatives represents a crucial step in combating the opioid epidemic while ensuring patients receive effective pain relief. Patients should always consult their physician or provider before starting a new course of medications.