Grant: Project Grant

Canada is experiencing a crisis of opioid use and abuse partially caused by excessive prescribing by doctors. Recent data show that approximately 20 Canadians die of opioid overdose every day. People often receive their first opioid prescription for pain treatment after an outpatient breast surgery (i.e., surgery to remove all or parts of the breast(s), where patients leave the hospital the same day), and many patients misuse these drugs and become addicted. Additionally, many of the opioid pills prescribed to patients are leftover and may be misused by family members, friends, or other community members. To prevent this problem, surgeons can avoid prescribing opioids by prioritizing opioid-free analgesia (i.e., pain treatment using only non-opioid interventions). Prescribing only non-opioid pain medications after surgery is very common in many countries outside of North America; however, few studies have assessed whether opioid-free analgesia is as effective as opioid analgesia after breast surgery. Therefore, the main question driving our study is: For patients who undergo outpatient breast surgery, is pain treatment without opioids as good as pain treatment with opioids? We are proposing a study comparing two groups of patients: one group will receive opioids to treat pain after surgery while the other group will receive only non-opioid medications. We will measure the impact of these different medication strategies on pain intensity, pain interference with daily activities, medication side effects, and other outcomes. We have assembled an expert team of scientists, surgeons, pain specialists, nurses, and patients to maximize the success of this study. Our results will provide important information to guide surgeons' decisions to prescribe (or not to prescribe) opioids. If opioid-free analgesia is found to be effective, in the future doctors may be able to substantially reduce opioid prescribing after breast surgery and prevent more people from misusing opioids.