Ronen ShechterJohns Hopkins Hospital, USA
Title: Collaborative surgical pain management with addiction medicine
In 2017, the United States Department of Health and Human Services declared a public health emergency to combat the Opioid Crisis. Federal, State, and Local Governments supported and allocated funds, hospitals and providers changed practices and we established the Johns Hopkins Perioperative Pain Program. The first couple of years looked promising, though despite all these efforts Opioid Crisis today is worse than ever. In 2021 compared to 2017 there was an increase in overdose death by about 40 percent and reached a record high of more than 100,000 overdose death in the US.
Data shows that prescribed opioids can contribute to the Opioid Crisis, though Addiction is likely a bigger cause of it. In recent years, The Johns Hopkins Acute Pain Service has been treating an increasing number of patients who suffer from Addiction. It managed their surgical pain with limited focus on their addiction. This has led to suboptimal pain control, missing addiction recovery opportunities, and possibly even increased their risk of overdose death upon discharge.
To address the increasing need for Inpatient Addiction services, a new Inpatient Addiction Service was established at Johns Hopkins in 2020. As a result, both Acute Pain and Inpatient Addiction Services started managing jointly these difficult patients perioperatively. In the beginning, Acute Pain Service focused mostly on managing the pain and the Inpatient Addiction Service on managing their addiction. Unfortunately, this has led to an incoherent treatment plan, and changing it into collaborative comprehensive management has been our focus. Our efforts have led to a remarkable improvement in all the aspects of these challenging patient population perioperative care. Our challenges, successes, and processes that we have taken to achieve it will be shared in the presentation.
Ronen Shechter is an assistant professor of Anesthesiology and Critical Care Medicine at the Johns Hopkins University School of Medicine. He serves as the Director of the Acute Pain Service and the Co-Director of the Personalized Pain Program. He earned his medical degree in 1999 from the Hebrew University Hadassah Medical School in Jerusalem and completed his training in Anesthesiology and a fellowship in Pain Medicine at Thomas Jefferson University Hospital. Following completion of an NIH T32 Postdoctoral Research Fellowship at Johns Hopkins University, he joined the department as a faculty. He has expertise in managing a wide variety of Acute, Subacute and Chronic pain conditions and his clinical and academic work focus on improving perioperative pain control and outcome.