SUBJECT: Opioid Addiction Prevention Act
Dear Senators Gillibrand and McCain,
On behalf of the American Association of Neurological Surgeons (AANS) and Congress of Neurological
Surgeons (CNS), representing more than 4,000 practicing neurosurgeons in United States, we applaud
the bipartisan efforts of the U.S. Senate to address our country’s opioid crisis and appreciate the ability to
be involved in this process. As neurosurgeons, we support legislation that reduces the risk of opioid
abuse. Limiting the availability of excess opioid medication in the postoperative period is one potential
way to accomplish this, and we generally concur with this approach.
There are, however, some postoperative scenarios, common in the practice of neurosurgery, where a 7-
day limit would be burdensome for patients. For example, complex spinal surgery typically necessitates
that patients appropriately utilize opioid medication to manage their postoperative pain for 2-3 weeks (or
even longer) after the surgery. Another example is polytrauma patients suffering from several concurrent
major injuries (e.g., multiple spine and limb fractures, head injury, etc.). These operations are often
performed by subspecialists in tertiary care medical centers that are located far from the patient’s
residences. In this situation, the patient would be forced to commute a long distance, merely to get a
prescription refill; thus subjecting these patients to an undue burden that likely would lead to undertreatment of their pain, and expose them to unnecessary postoperative complications and poor
outcomes.
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