Ensuring Safe Prescribing of Controlled Substances for Pain Following Surgery by Developing a Transitional Pain Service

SUMMARY

Chronic postsurgical pain is a significant complication following major surgery, which impairs patient’s quality of life. Opioid medications are the mainstay of most postoperative analgesic regimens. Growing evidence suggests inherent risks associated with opioids used for postoperative pain. Beyond common opioid-related side effects, increased mortality in the community and developing persistent opioid problems have been reported. There is a paucity of literature regarding the safe and effective management of postoperative pain as patients transition from the hospital to home/community. The introduction of a transitional pain service, whose aim is to optimize pain control, monitor and appropriately wean patients off opioid medications, prevent unnecessary readmissions post-discharge, and reduce disability associated with the development of chronic post surgical pain, will be of benefit to patients and the healthcare system.

KEYWORDS::

• acute pain
• chronic postsurgical pain
• major surgery
• opioid prescription monitoring
• opioid use
• postsurgical pain
• transitional pain service

Financial & competing interests disclosure

H Clarke is supported by a merit award from the Department of Anaesthesia at the University of Toronto and by the STAGE Training Program in Genetic Epidemiology from the Canadian Institutes of Health Research. J Katz is supported by a Canada Research Chair in Health Psychology at York University. Funding for the inception of this service was provided bythe Ministry of Health and Long-Term Care (Ontario, Canada) and by the Ontario Medical Association. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

H Clarke is supported by a merit award from the Department of Anaesthesia at the University of Toronto and by the STAGE Training Program in Genetic Epidemiology from the Canadian Institutes of Health Research. J Katz is supported by a Canada Research Chair in Health Psychology at York University. Funding for the inception of this service was provided bythe Ministry of Health and Long-Term Care (Ontario, Canada) and by the Ontario Medical Association. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.