AKRON, Ohio — Orthopedic surgeons at Akron Children's Hospital are reducing the number of narcotic prescriptions for kids in response to the national opioid epidemic.
"We have reduced the amount of narcotics prescribed by approximately 44% while maintaining good pain control after surgery," said Dr. Kerwyn Jones.
Beginning in 2017, nine orthopedic surgeons began to analyze their own pain prescribing practices and how they compared with peers elsewhere.
"The opioid epidemic, a multifactorial issue with many causes, is one of the most alarming public health concerns of our time and it is imperative that providers recognize prescribing patterns that may be contributing to the problem," Jones said. "And while, worldwide, efforts are being undertaken to improve adult pain management, very little has been done in pediatrics."
Working with colleagues in Akron Children's Pain Center and Pharmacy, the team established a standardized approach to prescribing pain medicine following orthopedic surgery. The new guidelines take into account whether the surgery is considered mild, moderate, major or a spinal fusion. Other guidelines include the patient's weight, whether her or she prefers pills of liquid medicine and if it's the first or second prescription.
Laminated pocket cards were given to all providers, including residents, for easy reference.
The hospital's electronic medical records team (EMR) was also involved, creating an order set that included the guidelines and discharge instructions. The team has since reported a 90% compliance rate for providers using the guidelines at discharge.
The post-operative pain management guidelines are on the website of the Pediatric Orthopaedic Society of North America and are being adopted by other pediatric health centers.
Other surgical teams at Akron Children's are working towards the same goal of standardizing pain management by the end of year.
"To accomplish change and make it sustainable, you must win hearts and minds," Jones said. "You have to share a compelling story while using the data to educate."
Lacey Wade helps people in recovery at ARC Recovery Services in Akron.
Wade recalled enjoying the 'euphoric feeling' she experienced when she was prescribed pain medication at the age of 16 following wisdom teeth surgery.
Eight years later, she was given more pain pills for a C-section and became hooked on the drugs.
"Once I started buying pills, I would just increase. I bought more pills, then I moved on to a different, stronger kind," Wade said.
Wade eventually started taking heroin and hit rock bottom in 2016 when she overdosed. She has been clean for more than two and a half years.
She is aware that addiction can potentially start at a young age if kids take pain pills and wonders if her own son is a prime example.
"My oldest son, he's 22 now, he was even prescribed pain pills as a small child (two times) and he's in recovery," she said. "He was in rehab at 16."
Wade praised the surgeons at Akron Children's Hospital for focusing on ways to reduce narcotic prescriptions.
"I feel like they have a responsibility to protect people from what they know could happen."
