Tackling the Opioid Crisis

Tackling the Opioid Crisis

Written by Miranda Cook

Old Boy Aiden Jabur ’17 has wanted to follow in his father’s footsteps as an orthopaedic doctor since primary school, inspired by their conversations about surgery over dinner.

Aiden never dreamed his medical research — aimed at tackling the opioid crisis — would be published in the prestigious British Journal of Surgery, despite having only just started as an intern doctor on the orthopaedic ward at Brisbane’s Princess Alexandra Hospital.

Two years ago while still at university, Aiden was part of a small group of ambitious medical students, from Australia and New Zealand, who were eager to research the use of opioid medication to treat pain after surgery.

“Having multiple hospitals around the world collaborate and collect data on one idea is a relatively new way of doing research.”

The study investigated patient-reported effects of opioid use once they were discharged from surgery, as well as the rate of patients representing at hospital due to inadequate analgesia or adverse effects.

Opioid-based medications are used to treat long and short-term pain; however, these prescription drugs can be highly addictive and have been exploited on a large scale in many countries since the 90s.

To have the study accepted in the British Journal of Surgery was huge validation that clinicians and academics care about our work.

“Over-prescription of opioids is a big factor contributing to the opioid epidemic — not to mention the cost of over-prescribing on the healthcare system,” Aiden said.

“We wanted to see if pain levels were high enough to warrant using opioids or if an opioid-free analgesia would be adequate.”

In most cases, doctors prescribe around 10 oxycodone immediate release tablets upon discharge “just in case” a patient experiences breakthrough pain when they get home, Aiden explained.

“It’s always nice to have stronger pain relief as a backup from a patient’s perspective, but the question is, is it needed?”

The findings revealed that prescribing opioids to treat pain after surgery didn’t improve patient satisfaction compared with non-opioid pain medications, like paracetamol and ibuprofen.

The study showed roughly 15 per cent of patients felt they were given an unnecessary amount of tablets, and patients in low-to middle-income countries — which are part of the Organisation for Economic Cooperation and Development (OECD) — reported spending the same amount of time in severe pain as those in high-income countries, despite being prescribed far less opiates.

“It doesn’t sound like a huge landmark finding, but it is.

“This is because it touches on an aspect of patient care that clinicians usually gloss over when prescribing discharge medications — we tend to do what’s always been done.”

Aiden hopes the findings lead to more patient-tailored care when it comes to prescribing, which would involve doctors asking patients more personalised questions about their pain, their past and how many tablets they’ve taken once discharged rather than “just giving everyone the same thing”.

“To have the study accepted in the British Journal of Surgery was huge validation that clinicians and academics care about our work and that something can be done about it.”