Opioid Discussion Navigator

Despite growing awareness of the opioid crisis, prescribing practices have been slow to change:

• Many surgeons still use prescribing guidelines from before the opioid crisis, when “adequate pain control” was prioritized above all other considerations
• Hospital protocols often default to “better safe than sorry” overprescribing rather than individualized plans
• Patients are rarely asked about their risk factors or preferences before prescriptions are written
• The assumption remains: “We’ll deal with problems if they come up” rather than preventing them proactively

Multimodal Pain Management

Smaller, Individualized Prescriptions

Result in equal or better pain control, fewer leftover pills, lower rates of chronic use, and higher patient satisfaction.

Pre-Surgical Pain Planning

Leads to better communication between patients and providers, more appropriate prescribing, earlier identification of patients who need additional support, and reduced anxiety about pain management.

Patient Advocacy in Prescribing Decisions

Correlates with 25-40% reduction in opioid pills prescribed, no increase in breakthrough pain requiring additional medication, and better functional outcomes.

Studies show that interventions like virtual reality, guided meditation, and distraction techniques successfully reduce surgical pain and anxiety. Patients in these studies reported feeling better.

But they still received the same amount of opioids as control groups.

Why? Because the prescribing decision had already been made. The intervention reduced their pain, but the prescription was based on the protocol, not on their actual experience.

This reveals the core problem: pain management decisions are made about you, without you, before you can provide input.

This tool changes that. It puts you in the conversation when decisions are being made.

People with elevated risk factors:

• Age 50 or older (highest risk group for post-surgical chronic opioid use)
• Personal or family history of addiction
• History of anxiety, depression, or other mental health conditions
• Currently taking opioids or other controlled substances
• Previous difficulty stopping medications after surgery

People who want to minimize opioid exposure regardless of risk level:

• Those who prefer to avoid medications when possible
• People who have had negative experiences with opioids
• Parents who don’t want opioids in their homes
• Anyone who wants to be proactive rather than reactive

People having surgeries with high prescribing rates:

• Orthopedic surgeries (knee/hip replacement, shoulder surgery)
• Spinal surgeries
• Abdominal surgeries
• Dental surgeries
• Any procedure where you’ve been told “you’ll need pain medication for several weeks”

Cost of this tool: $29

Time investment: 2-3 hours of preparation

What you’re potentially avoiding:

• 10% risk of chronic opioid use → $35,000-$175,000 in treatment costs
• Average leftover pills: 15-30 pills that remain in your home
• Risk of diversion: those pills being found or taken by family members
• Years of recovery time if dependence develops
• Immeasurable personal and family costs

From a purely financial perspective: If this toolkit helps reduce your risk of chronic opioid use from 10% to even 7%, the expected lifetime savings from avoided complications and follow-up care average $1,050–$5,250.

From a quality-of-life perspective: The value of avoiding opioid dependence is incalculable.

“My doctor knows best” – True, but your doctor is working within systems and protocols that weren’t designed with current opioid crisis knowledge. Your doctor is also seeing 20+ patients per day and may not have time to customize unless you request it.

“I’ll just be careful” – Dependence doesn’t happen because people are careless. It happens because opioids are physiologically addictive, and surgical pain creates a perfect storm: you’re in legitimate pain, you have easy access, and you’re told to “stay ahead of the pain.”

“I’m focused on the surgery, not the pills” – Understandable. But this is exactly why overprescribing happens. The 20 minutes you spend on pain management planning now saves you from months of problems later.

“It won’t happen to me” – This is what everyone thinks. The 1 in 10 who become chronic users all thought this too. Risk factors help identify who’s most vulnerable, but anyone can be affected.

“I’ll deal with it if it becomes a problem” – Opioid dependence is exponentially harder to address after it develops than to prevent before it starts. You can’t “deal with” addiction through willpower alone.