Pain – The Health Care Blog

How Routine Medical Care Fuels America’s Opioid Crisis

Mar 17, 2025

By MATT McCORD

When most Americans undergo surgery, they expect to recover quickly and return to their normal lives. Few realize that something as routine as a shoulder surgery, a hernia repair, or a mastectomy can mark the beginning of a life-altering opioid addiction. This often-overlooked connection between routine medical care and opioid dependence demands urgent attention.

How Physicians and Hospitals Sustain the Opioid Epidemic

For decades, the pharmaceutical industry has shaped medical education, ingraining the belief that opioids are the best first-line treatment for acute pain. As a result, American physicians prescribe opioids at dramatically higher rates than their counterparts in other countries. A recent study in Annals of Surgery found that after three common surgeries, 91% of U.S. patients were prescribed opioids, compared to just 5% of the global patients.

Hospitals and health systems have also played a significant role in perpetuating opioid dependence. Opioids have long been a convenient and cost-effective solution for acute pain management, readily available and inexpensive to administer. However, the financial incentives for hospitals extend far beyond the initial prescription. The short-term complications of opioid use—such as nausea, constipation, urinary retention, and hyperalgesia—require additional treatments, increasing hospital revenue. Long-term complications, including dependence, overdose, and addiction, further drive profitability through repeat admissions, extended care, and emergency visits. In effect, hospitals and health systems have become financially reliant on opioid-based care, benefiting from both the immediate and prolonged consequences of opioid prescribing.

A study from the University of Michigan/IBM Watson revealed that a single opioid prescription after elective surgery increased healthcare costs by an average of $5,680 per patient per year across all payer types, including Medicare, Medicaid, and commercial insurance. This widespread cost increase affects insurance premiums, employer healthcare spending, and state and federal budgets. Notably, this estimate does not even account for the long-term costs of addiction treatment, which can be 2-16X that cost per patient per year.

The Devastating Impact of Routine Opioid Prescriptions

Each year, over 60 million surgeries are performed in the U.S., leading to the prescription of 45 million new opioid prescriptions per year. But the real crisis lies in what happens next: nearly 10% of all surgical patients remain on opioids long after their recovery should be complete. That means 2-4 million Americans every year are still using opioids beyond 90 days post-surgery.

The Joint Commission Pain Standards: Five Misconceptions

Apr 18, 2016• 5

By DAVID W BAKER, MD

Baker_David_275 In the environment of today’s prescription opioid epidemic, everyone is looking for someone to blame. Often, The Joint Commission’s pain standards take that blame. We are encouraging our critics to look at our exact standards, along with the historical context of our standards, to fully understand what our accredited organizations are required to do with regard to pain.

The Joint Commission first established standards for pain assessment and treatment in 2001 in response to the national outcry about the widespread problem of undertreatment of pain. The Joint Commission’s current standards require that organizations establish policies regarding pain assessment and treatment and conduct educational efforts to ensure compliance. The standards DO NOT require the use of drugs to manage a patient’s pain; and when a drug is appropriate, the standards do not specify which drug should be prescribed.

Our foundational standards are quite simple. They are:

The hospital educates all licensed independent practitioners on assessing and managing pain.

The hospital respects the patient’s right to pain management.

The hospital assesses and manages the patient’s pain.

Requirements for what should be addressed in organizations’ policies include:

What Killed Scott Weiland?

Dec 7, 2015• 2

By JOSEPH KRAININ, M.D.

His voice had the unusual ability to convey both aggressive muscularity and profound vulnerability. Scott Weiland and Stone Temple Pilots were icons of my adolescence. Personally, my memory of Mr. Weiland will always be inextricably linked with “Plush,” that initial hit single which, upon first listen, instantly captivated me and thousands of other kids like me. During my high school days, “Plush” was elevated to the highest sonic status possible, joining Metallica’s “Enter Sandman” and Pearl Jam’s” Black” as an essential component of our football team’s pre-game locker-room pump-up playlist.

So it was with shock and sadness that I read in the New York Times this morning that Weiland had “died in his sleep” on Thursday during a tour stop in Bloomington, MN. He was 48.

Using a Mobile App for Monitoring Post-Operative Quality of Recovery

Mar 2, 2015• 5

By JAAN SIDOROV, MD

While your correspondent is tantalized by the prospect of healthcare consumers using mHealth apps to lower costs, increase quality and improve care, he wanted to better understand their real-world value propositions.