feature Surgery is a tool used to heal our bodies. To stitch them up when they are broken, to remove foreign bodies that are making us sick. But a national prescription drug abuse crisis has many hospitals fighting to keep weapons of healing from turning into weapons of harm.
A national epidemic
few opioids as possible while they are here and in the operating room. People who are depressed, abuse alcohol, or who have chronic pain, are prone to overdose on prescription medication,” says Dr. Baltazar. “And how do we do it? By using our nerve blocks. Also, by using non-opioid medication like IV Tylenol,” he said. “We did it to ourselves around 1990 with our vital sign measurements. We didn’t want our patients to hurt. So, what did we do? We really did a knee jerk reaction. We pumped them with all this medication. All these opioids and look what happened,” he said.
Ninety-one Americans die every day from an opioid overdose. That means that opioids now kill more people than car accidents. The number of unintentional overdose deaths from prescription pain relievers A different approach has soared in the United States, more than quadrupling since 1999. As a result of addiction, some addicts even turn to heroin When a patient undergoes surgery, a abuse when they are combination of medications— unable to find the pain often referred to as a cocktail— relief they need. may be used to sedate the patient and relieve pain. Today’s These aren’t people understanding of the human on the streets, or junkies. “33,000 a year die. It body allows for patients to be These are mothers and awake for many procedures. The teenagers, fathers who had used to be what you call a absence of general anesthesia back surgery and never straight overdose. Now, it’s means a faster recovery time, found true relief from prescription drug overdose.” less pain, and an intact immune the pain, and even dental system. patients asking for one DR. ROMEO BALTAZAR more refill. “General anesthesia depresses your immune system. Several factors By not giving the general contribute to the severity anesthesia, your immune system of the current prescription stays intact so it is able to fight drug abuse problem. They infection. It’s common sense,” he said. include drastic increases in the number of prescriptions written and dispensed, greater Patient surveys at Hunt Regional typically social acceptability for using medications for reveal great pain management and an different purposes, and aggressive marketing by overwhelming appreciation for our nerve pharmaceutical companies. block protocol. Dr. Baltazar attributes our success to doing this differently than many Hunt Regional’s medical director for organizations. anesthesiology, Romeo Baltazar, MD, is combating that epidemic locally with the use “In studies of 10,000 total knee of nerve blocks and a commitment to finding replacements around the United States, they new methods to combat pain after surgery. found that only 20% of those people who had total knee replacements had some kind of “Every year, 33,000 die. It used to be nerve block or epidural, while 80% received what you call a straight overdose. Now, it’s general anesthesia,” said Dr. Baltazar prescription drug overdose. If you combine the use of cocaine, Fentanyl, and heroin, “It is the reverse at our institution. We do prescription overdose is twice as much around 90 to 95% epidural with our total joint compared to street drugs overdose. This is replacements. Because studies have shown that only in America,” said Dr. Baltazar. when you do spinal anesthesia, it decreases the amount of blood loss. The most important Last fall the Surgeon General gave a call to thing research shows is that it decreases your action to healthcare providers, asking for help surgical site infection risk,” he said. in combatting prescription drug overdose. Which cocktail is used and how long “One of the answers to this is to use as 16 / healthbeat /
