American Association of Neurological Surgeons and Congress of Neurological Surgeons
Commitment on Countering the U.S. Opioid Epidemic
The American Association of Neurological Surgeons (AANS), the Congress of Neurological Surgeons
(CNS), and the AANS/CNS Joint Section on Pain (www.painsection.org and @painsection) are
committed to the neurosurgical treatment of acute and chronic pain, as well as to advancing pain care
through education, research and advocacy. We are also committed to countering the U.S. opioid
epidemic.
Leading the Way in the Treatment of Pain
Historically, neurosurgeons have been at the forefront of the treatment of pain for many decades,
producing seminal texts describing mechanisms of pain and devising innovative surgical
techniques. Additionally, organized neurosurgery has created the largest prospective database of
spinal surgery patients to improve patient selection and outcomes for these procedures. We
continue to lead the way in advancing surgical therapies that relieve pain through less invasive
approaches. Neurosurgeons were also the original practitioners of both ablative nervous system
procedures for intractable pain as well as nondestructive neuromodulation techniques such as
spinal cord stimulation. These therapies represent an alternative to opioid-based therapy, and we
are committed to bringing forward more treatments such as these that improve function and
quality of life while reducing reliance on opioids. Neurosurgeons are also researching enhanced
recovery after surgery (ERAS) protocols that reduce postoperative opioid requirements.
Educating Clinicians and the General Public
Neurosurgeons educate clinicians and the general public about the appropriate use of surgical
therapies for the treatment of pain and their opioid-sparing benefits. We are constantly working to
increase awareness regarding these advantages and train neurosurgeons in the best practices of
these procedures to improve long term outcomes. In addition, we are actively educating our
colleagues in both appropriate opioid prescribing practices and in the use of opioid-free post-surgical analgesic regimens.
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