Doctors find Alternatives to opioid use

Amber Mccanna’s hip replacement in 2016 was her sixth surgery in 10 years. It was also the start of a life without opioids.

Mccanna, 37, spent years hooked on powerful daily doses of opioids prescribed by her doctors for chronic joint pain. But when she had her most recent operation, it was with the help of an approach that minimizes the use of the highly addictive painkillers that have riven communities and ruined lives across the

U.S.

“I haven’t had any narcotics since then,” the mother of three said. “I’ll never allow myself to be dependent on opioids again.”

Mccanna is at the forefront of a new movement in U.S. medicine to fight drug dependency. Despite malpractice lawsuits costing millions of dollars, dozens of physician convictions by the Drug Enforcement Administration for criminal misuse of painkillers and 33,000 overdoses in 2015, doctors are still writing hundreds of millions of opioid prescriptions every year. Now, some surgeons and anesthesiologists are trying to squeeze opioids out of the operating room.

Doctors don’t have the luxury of time to wait for a new generation of opioid-free painkillers that companies are racing to develop. So they’re turning to long-established drugs similar to Novocain, a favorite of dentists, to perform procedures using an approach not unlike the epidurals women often receive during childbirth.

The difference is that anesthesiologists target specific joints, such as the shoulder, knee or hip. They’re also increasingly recommending alternatives such as massage and meditation to supplement drugs for pain control.

David Auyong and Neil Hanson, anesthesiologists at Virginia Mason Medical Center in Seattle, have been encouraging the use of nerve blocks that numb specific parts of the body, rather than opioids whose effects reach the lungs, gastrointestinal system and the brain. Guided by ultrasound imaging, Auyong guides a catheter into spaces where he can bathe individual nerves with bupivacaine, a long-acting, numbing drug.

After surgery, pumps continue to deliver the drug directly to the nerves for two to four days until the most intense pain subsides. Using this technique, Auyong and Hanson were able to substantially reduce the amount of opioids patients received for total knee-replacement procedures. They’ve also been able to cut the length of hospital stays, as patients are ready to move and walk sooner after surgery.