Opioid prescribing in the wound care patient

Wound care specialists are presented with the challenge of achieving optimal pain therapy for patients experiencing acute, chronic and postoperative pain. Comfort is the ultimate goal when using pain medication to manage pain. Realistic expectations and acceptance of pain as a normal part of healing is important to this goal.¹

Opioid prescribing presents a myriad of serious risks for patients taking these medications.² Each opioid produces a wide spectrum of pharmacological effects, including: analgesia; dysphoria; euphoria; somnolence; respiratory depression; diminished gastrointestinal motility; altered circulation; urinary retention; histamine release; and physical dependence.¹

In the period 1999–2014, >165,000 deaths and >420,000 emergency department visits were attributed to opioid overdose.³ On an average day in the US States, >650,000 opioid prescriptions are dispensed.⁴ It is estimated that the US consumes 80% of the global opioid supply as well as approximately 99% of hydrocodone.⁵ The US is in the midst of an ‘opioid crisis’, and according to the 2021 National Survey on Drug Use and Health, 8.2 million adults misused prescription pain relievers at least once in the previous year, with approximately 1.2 million of those in a non-metropolitan area.⁶ Ringwalt et al.⁷ reported a review of 1.28 million filled prescriptions and asserted their findings centered on medical specialty opioid prescribing for non-chronic, non-cancer pain. Orthopaedists were most likely to prescribe opioids for the management of acute and postoperative pain, normal prescribing habits, stemming from surgical interventions.