As the opioid epidemic rages on — 3,040 Michiganders died of opioid overdoses in 2021 according to the U.S. Centers for Disease Control and Prevention — anesthesiologists at Michigan Medicine are leading the way in utilizing holistic, innovative methods to better treat pain, reduce the use of opioids and keep patients safe.
“It’s critical for anesthesiologists to have a strong collaboration with our surgical colleagues to identify patients at risk of opioid dependence and overuse at the forefront and take a tailored approach to their care,” said Dr. Melissa Byrne, regional anesthesiologist and associate program director for the Michigan Medicine’s Anesthesiology Residency Program.
While opioids are not recommended for chronic pain in most circumstances, they can have a role in certain surgical contexts. The Michigan Opioid Prescribing Engagement Network, in partnership with Michigan Medicine, developed evidence-based guidelines for prescribing opioids after surgery. As a result, surgeons are prescribing fewer opioids thanks to the work of the Michigan anesthesiology community.
“One of the keys to curbing opioid use is for anesthesiologists who specialize in pain management to be involved with patient care early in the process, well before patients end up on the operating room table,” said Dr. Paul Hilliard, medical director of institutional opioid and pain management strategy and division director of pain management at Michigan Medicine’s Department of Anesthesiology.
Anesthesiologists at Michigan Medicine are piloting a program with spine surgeons to offer patient interventions such as exercise and lifestyle changes prior to needing surgery. Michigan Medicine’s pain clinic offers acupuncture, integrated medicine, behavioral health services and biofeedback therapy.
If surgery is still needed, the anesthesiologists oversee the entire experience and follow the patient’s progress for three months after surgery to reduce the amount of opioid medication needed to manage pain and keep patients safe. They recently introduced a patient peer program, in which people who have been through similar experiences are vetted, go through special training and then are available to talk to patients about their journey.
“There’s a misconception that anesthesiologists are just involved at that moment in the operating room to put a patient under anesthesia,” said Dr. Goodarz Golmirzaie, program director for ACGME pain fellowship and associate director for pain medicine at Michigan Medicine. “Anesthesiologists have a deep understanding of the course of different medical procedures, allowing us to navigate and direct resources in our pain clinic and take an active role in our patients’ continuum of care.”
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