[Verse 1] Post-op patient waking up, pain is climbing fast Non-opioids came first, that's the protocol we passed Acetaminophen stacked, NSAIDs in the mix Regional blocks deployed before we reach the fix But when the multimodal spread ain't cutting through the haze Acute opioids step in for a strictly numbered phase Immediate-release only, short-acting is the rule Extended-release concurrent? Nah, that ain't the tool [Chorus] IR first, short duration, quantity controlled No ER concurrent, that's the doctrine we uphold Dispose the excess, educate before they leave Post-discharge predictors — watch the patient, watch the need IR first, short duration, tight supply Persistent use creeping in, we gotta recognize the signs [Verse 2] Michigan OPEN did the math, procedure-by-procedure counted Wisdom teeth removal — four days, don't surpass it Laparoscopic chole? Maybe five at most Hernia open repair, the data drives the dose Not a blanket script you write without the evidence to back Tailor to the surgery type and document the track Patient leaves with naloxone, lock box in the home Disposal instructions, don't leave unused pills alone [Chorus] IR first, short duration, quantity controlled No ER concurrent, that's the doctrine we uphold Dispose the excess, educate before they leave Post-discharge predictors — watch the patient, watch the need IR first, short duration, tight supply Persistent use creeping in, we gotta recognize the signs [Bridge] Now persistent postoperative use — let's break it down cold Roughly six to ten percent keep filling past the threshold Preoperative opioid history, that's predictor number one Anxiety, depression, substance use — the vul-ner-a-bil-i-ty run Catastrophizing pain behavior, chronic preexisting sites Higher intraoperative doses correlate with longer nights Prevention starts before the knife ever breaks the skin Screen the psychosocial factors, build the plan back then [Verse 3] Counsel every patient: pain resolves but pills persist The leftover supply is how addiction gets a fist Opioid naïve patients face the steepest slippery slope Three days stretches into thirty if nobody intervenes the hope Prescription drug monitoring programs, check before you sign One prescriber, one pharmacy, one patient at a time Quantity limits aren't just policy, they're pharmacologic sense Lower total exposure means lower consequence [Chorus] IR first, short duration, quantity controlled No ER concurrent, that's the doctrine we uphold Dispose the excess, educate before they leave Post-discharge predictors — watch the patient, watch the need IR first, short duration, tight supply Persistent use creeping in, we gotta recognize the signs
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