PROJECT rEASON

Rural Emergent Alternative Surgical Opioid Non-use

Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

Karen R. Boretsky, MD & Sam Reiga, BSN, RN, MBA

Project Resources

Rural Emergent Alternative Surgical Opioid Non-Use, funded by HRSA, provides expert-guided education focused on opioid-sparing analgesia guidelines to health care providers, patients, and families to mitigate surgically-gated opioid use disorder at one-year follow-up. A standard of care will be developed for providers, patients, and parents/legal guardians to communicate with surgeons and anesthesiologists on how to request non-opioid surgical options.

Series Recordings and Tools

CE credits were available for live attendance only.

Alternative Surgical Opioid Use: Curriculum Introduction

Presented on March 8, 2021

Part One of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

  • Objectives:
    • Understand the problem of surgery as a gateway to persistent opioid use
    • Discuss the prevalence of opioid use disorder as a complication of surgery
    • Identify risk factors for post-surgical persistent use of opioids
    • Identify high risk patient populations and factors
    • Understand factors in opioid over-prescribing and how you can make a positive impact
    • Discuss multimodal, multidisciplinary pain management

Presentation

Module 1 – rEASON Curriculum Intro

Opioids: From Friend to Foe

Presented on March 22, 2021

Part Two of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

  • Objectives:
    • Understand the problem of surgery as a gateway to persistent opioid use
    • Discuss the prevalence of opioid overuse as a complication of surgery
    • Discuss opioid sparing alternatives to opioid monotherapy
    • Understand opioid related adverse drug effects and the impact on clinical and cost outcomes
    • Understand the complexity of pain pathways and why multiple analgesic techniques improve outcomes
    • Discuss multimodal, multidisciplinary pain management

Presentation

Module 2 – Opioids; From Friend to Foe

Opioid Induced Hyperalgesia

Presented on April 5, 2021

Part Three of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

  • Objectives:
    • Understand the problem of surgery as a gateway to persistent opioid use
    • Discuss development of opioid induced hyperalgesia in the post-surgical patient
    • Discuss the complexity of pain pathways and why multiple analgesic techniques improve outcomes
    • Discuss historical observations of opioid induced hyperalgesia
    • Understand the challenges of managing opioid induced hyperalgesia
    • Discuss opioid sparing alternatives to opioid monotherapy

Presentation

Module 3 – Opioid Induced Hyperalgesia

Adolescents and Young Adults;  Uniquely Susceptible to OUD

Presented on April 19, 2021

Part Four of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

Objectives:

  • Understand the problem of surgery as a gateway to persistent opioid use
  • Discuss why adolescents & young adults are uniquely susceptible to oud
  • Discuss opioid sparing alternatives to opioid monotherapy
  • Discuss how adolescent brain development contributes to addictive vulnerability
  • Discuss illicit drug use in Grades 8 through 12
  • Discuss persistent use of opioids in pediatric patients following surgery

Presentation

Module 4 – Adolescents and Young Adults; Uniquely Susceptible to OUD

Multimodal Analgesia; Concepts & Implementation: Regional Anesthesia

Presented on May 3, 2021

Part Five of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

Objectives:

  • Discuss the prevalence of opioid overuse as a complication of surgery
  • Value multimodal pain management
  • Understand the role of regional anesthesia as an alternative to opioids for the management of surgical pain
  • Recognize the difference between major block techniques
  • Recognize patient misgivings about regional anesthesia
  • Formulate strategies to allow patients to advocate for regional anesthesia as an alternative to opioids

Presentation

Module 5 – Multimodal Analgesia; Concepts &   Implementation:  Regional Anesthesia

Multimodal Analgesia; Concept and Implementation: NSAIDs

Presented on May 17, 2021

Part Six of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

Objectives:

  • Understand the problem of surgery as a gateway to persistent opioid use
  • Discuss the prevalence of opioid overuse as a complication of surgery
  • Discuss opioid sparing alternatives to opioid monotherapy
  • Understand NSAIDs as a key component of multimodal analgesia
  • Understand post-operative implication of NSAID use
  • Discuss Multimodal, Multidisciplinary Pain Management

Presentation

Module 6 – Multimodal Analgesia; Concepts &   Implementation: NSAIDS & Alternatives

Putting It All Together; Developing Your Safe & Effective Pain Management Plan

Presented on June 14, 2021

Part Seven of the series: Closing the Door on Surgery as a Gateway to Persistent Use of Opioids

Objectives:

  • Understand the problem of surgery as a gateway to persistent opioid use
  • Discuss the prevalence of opioid overuse as a complication of surgery
  • Discuss opioid sparing alternatives to opioid monotherapy
  • Understand opioid related adverse drug effects and the impact on clinical and cost outcomes
  • Understand the complexity of pain pathways and why multiple analgesic techniques improve outcomes

Presentation

Module 7 – Putting It All Together; Developing Your Safe & Effective Pain Management Plan

Raoul RolfesrEASON