Patients at Pittsburgh hospital can enter opioid-free pain management program
PITTSBURGH (KDKA) — For the first time in western Pennsylvania and possibly in the nation, patients at a local hospital can choose not to be given opioids before, during and after surgeries.
Inside UPMC Shadyside Hospital, doctors are taking a unique route to managing surgical and post-op pain in some patients to help prevent opioid use disorder.
Dr. Shiv Goel, chief of anesthesiology and perioperative medicine at UPMC Shadyside, said the whole team at the hospital worked to launch its opioid-free pathway in May in response to patient demand.
"We had been seeing a lot of patients coming into the hospital for surgery asking specifically not to use opioids for their pain management. And so far, there was never any defined pathway that existed that would ensure that a patient who's making such a request gets that option and that request is honored. For the first time, this gives the power to the patients to choose the type of pain medications they want to take for managing their pain," Goel said.
For surgical pain, they use regional anesthesia, nerve blocks, local anesthesia or non-opioid IV medications.
For post-op pain, in addition to meds, patients can also choose from techniques like aromatherapy, acupuncture, hypnosis, music therapy and biomedical devices. The doctors help to address anxiety, which contributes to pain.
"All of that does tie into decreasing how they perceive their pain. If their anxiety goes down, they perceive pain less," Goel said.
Amy Hartzer had a partial mastectomy for breast cancer last month.
"I've heard it's as bad as dental surgery and people getting hooked on opioids. I thought, yeah, there's an opioid-free pathway, sign me up," Hartzer said.
Hartzer was happy to have control over her pain management, especially because she's starting chemo in a few weeks. She didn't want to have more complications.
"I actually had a nerve block, and the doctor explained what that would be like. And I have to be honest, I'm glad I went the opioid-free because had I not and they would have given me opioids, it would have been for no reason. I was never in a lot of pain," she said.
Patients wear a special bracelet and stickers are added to charts so everyone is on the same page with their pain management plan.
Lead coordinator of the opioid-free pathway at UPMC Shadyside Heather Margonari says patients can opt out at any time. She said 39 patients have enrolled in the pathway in just over two months.
"Some of them do have a family history of addiction, and some of them have addiction use themselves. But there are also a lot of people that have had these opioids in the past and have had bad reactions to them with side effects," Margonari said.
They hope this one-of-a-kind approach can prevent people from feeling the pain of opioid use disorder.
"Patients seem to be much happier on the pathway. They're definitely more alert. And I think they also feel empowered that they're choosing to do this opioid-free, and their wishes are being followed," said Margonari.
"That is a problem which has been created by the health profession itself. There was a time when we started calling pain the fifth vital sign. We created unrealistic expectations for our patients. .. I think we owe it to ourselves and our patients and to our country to try to right this wrong, which was being perpetuated on all our patients," Goel added.
People interested in learning more about this opioid-free pathway can reach out to the team at UPMC Shadyside.