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Operation without opioids: No pain, no pain pills

Older Americans most at risk for dependence

***EMBARGOED: Phoenix, AZ*** America's opioid epidemic continues: The latest numbers from the Centers of Disease Control and Prevention, released Friday, show that one in four drug overdoses in 2015 was related to heroin. In 1999, just 6% of all overdoses were related to the drug.
***EMBARGOED: Phoenix, AZ*** America's opioid epidemic continues: The latest numbers from the Centers of Disease Control and Prevention, released Friday, show that one in four drug overdoses in 2015 was related to heroin. In 1999, just 6% of all overdoses were related to the drug. (KPHO via CNN)

MIAMI, Fla. – The U.S. is in the middle of an opioid epidemic, but it might surprise you to learn that older Americans are most at-risk of dependence.

A recent study found the number of seniors who misuse pain pills will have doubled between 2004 and 2020. Now a new approach to managing pain after surgery is hoping to change that.

At the age of 88, Marvin Wiener still enjoys a good game of golf. 

“It’s a very good challenge; it’s outside," Wiener said.

But Wiener’s swing stopped when he needed shoulder replacement surgery. Like most patients, he worried about pain after the operation.

Orthopedic surgeon Dr. Vani Sabesan at Cleveland Clinic Florida said that chronic pain can lead to opioid dependence in the elderly population. That’s why she’s changing the patient-doctor approach to surgery at Cleveland Clinic Florida.

“I think opioids are not the only way. They’re honestly probably not the best mechanism to treat patient’s pain,” Sabesan said.

Instead, she educates the patient beforehand about the opioid crisis. Then she provides alternatives that minimize pain starting in the operating room. 

“We do a block, where we put local anesthetic around your nerves, and that is effective in providing pain relief for the first 12 to 24 hours,” Sabesan said.

Patients are encouraged to ice the area and take anti-inflammatory medications.

“I’ve had 40 patients who have had a shoulder replacement, a rotator cuff surgery, and they’ve not taken a narcotic medication after surgery,” Sabesan said.

Follow-ups found those patients had better function after their operation. Wiener shocked his doctors when he was asked to describe his pain level.

“They were somewhat surprised when I said zero a few days after surgery,” Wiener said. 

Now he’s back to the links and enjoying life to the fullest. 

Sabesan is hoping this new approach to managing pain will become a global standard of care. She also recommends early rehabilitation to patients after surgery to get the joints moving.