Management of Patients on Abuse-Deterrent Opioids in the Ambulatory Surgery Setting

The use of prescription opioids for acute and chronic pain has become more prevalent than ever, and concurrent with the increased prescribing of opioids, there has been a steady increase in opioid abuse. Abuse is commonly associated with physical or chemical manipulation of the original opiate to provide more rapid onset of the active ingredient.

This growing national public health concern has led to the development of various abuse-deterring opioids with the intent of decreasing the diversion of opioids from their prescribed use. Given the ever-increasing percentage of surgeries performed in the ambulatory surgery setting, anesthesia providers will inevitably encounter more and more patients taking these new opioid formulations with abuse-deterring properties. Consequently, a thorough understanding of these medications is vital for optimal anesthetic management. This article reviews the scope of the problem of prescription opiate abuse, summarizes the currently available abuse-deterring opioids, and discusses the anesthetic management of patients who are taking these new medications in the outpatient setting.