Collaborative breakthroughs in the nationwide opioid epidemic

Englesbee Lee and HowardAccording to the Centers for Disease Control and Prevention, 115 Americans die every day from an opioid overdose, many of them resulting from the abuse of prescribed medications. U-M researchers are helping to curb this dangerous epidemic is through research into the origins of the problem as well as a search for solutions through safer prescribing practices, adequate counseling and alternative methods for pain control.

Michael Englesbe M.D., along with Ryan Howard, M.D. and Jay Lee, M.D., led a study showing that the average patient received a prescription of 250 milligrams of opioid medications, about 50 pills, after gallbladder removal but most took only 30 milligrams, or six pills, of their prescription. The rest was often still sitting in their medicine cabinets, even years after surgery.

When U-M surgical leaders heard these findings, they gave the researchers the green light to develop and roll out a much lower prescribing guideline, paired with a new patient education effort about pain control. The result: At Michigan Medicine, the average prescription for gallbladder surgery patients dropped 66 percent, to 75 milligrams of opioids, or 15 pills, in the 200 patients treated in the first five months after the guideline went into effect.

Based on the results, the team decided to take the guideline effort statewide. Using data from patients who had surgery at dozens of Michigan hospitals taking part in the Michigan Surgical Quality Collaborative, the team has developed prescribing recommendations for 11 common operations, published on the reference website,

Through basic science to policy insights, research at U-M can help change how healthcare providers address pain and hopefully spare patients and their loved ones, as well as society at large, from the life-altering effects of opioid addiction.

Pictured together above are Michael Englesbe, M.D., F.A.C.S., Endowed Professor of Transplantation Surgery and Jay Lee, M.D., health services research fellow with the Center for Healthcare Outcomes & Policy and a General Surgery resident. Ryan Howard, M.D. is a General Surgery resident.

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