The University of Michigan will use a new $3.6 million federal grant to study how pain and opioids after surgery impact people with opioid use disorder, how guidelines might be adjusted to address post-surgical pain and how to prevent opioid-related harms.

The five-year study funded by the National Institutes of Health will ask patients undergoing common surgeries at hospitals across Michigan to document their post-surgical pain and their use of opioids for relief. These and other data sources will be used to develop post-surgical care guidelines that focus on pain management and preventing harm from opioids for this challenging clinical situation.

"We must listen to individuals with opioid use disorder directly to understand how to best approach solutions and strategies for their care and learn how to adjust care plans without inadvertently causing negative outcomes," said Mark Bicket, associate professor of anesthesiology and lead investigator on the project. "This study and its findings will help us do just that."

In 2021, an estimated 2.5 million people aged 18 years or older in the U.S. had opioid use disorder in the past year, according to the National Institute on Drug Abuse. Those with the disorder experience greater challenges in managing acute pain and are also at a greater risk for opioid-related harms, especially during post-surgical care, one of the most common reasons for opioid prescribing.

However, there is little evidence to guide post-surgery pain management and reduce opioid-related complications for individuals with the disorder.

"Addressing opioid-related harms is a complex issue and requires comprehensive solutions," said Bicket, who is also an associate professor of health management and policy in the School of Public Health.

The study intends to address the existing knowledge gaps and adapt current prescribing guidelines for common elective and non-elective surgical procedures to improve pain management for patients with opioid use disorder.

"As clinicians, it is our responsibility to provide patients with the best care possible, so understanding the relationship between post-surgical opioid prescribing for those with opioid use disorder is critical to providing patient-centered care," said Jennifer Waljee, an associate professor in the U-M Medical School and co-principal investigator of the project.

The data that is gathered will also inform the development of a structured, multidisciplinary care plan designed to assist healthcare providers in making clinical decisions for individuals with the disorder. Researchers will then evaluate the effectiveness of the care plan which will include care coordination, overdose prevention, peer recovery coaching and pain management recommendations.

"Ensuring there is alignment in prescribing opioids and reducing opioid-related harms is paramount," said Waljee, who is also a plastic surgeon at Michigan Medicine.

Bicket and Waljee are both faculty affiliate members of U-M's Opioid Research Institute and serve as executive directors of the Overdose Prevention Engagement Network, which is also hosted at U-M.

Written by Kate Barnes, Office of the Vice President for Research

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