Dr. Tyler Goldberg fights the opioid crisis one patient at a time.
He's not prescribing painkillers after reconstructive joint surgeries. At least not as much as he used to.
"If I can kind of intervene prior to them ever getting addicted or using those narcotics to use to control their pain, then maybe I can stop a little bit of this post-operative addiction tendency," Dr. Goldberg said.
Dr. Goldberg said he decided to stop prescribing narcotics after surgeries for 85 percent of his patients because he is seeing too many people affected.
"There is an opioid crisis in the United States," Dr. Goldberg said.
His pain protocol starts with conversations with patients about pain relief that includes Tylenol, lots of ice, anti-inflammatory medications and lots of movement post operation.
Bunny Christie had both knee replacement surgeries done by Dr. Goldberg. Her right knee a year and a half ago, and her left knee two weeks ago.
The most recent operation was narcotics free, which was fine for the 62-year-old Christie.
"Because I was so 'ehhh' the first time. ... It was over two weeks before I got into the swing of things," she explained.
"People can become addicted or develop physical dependence on opioids in less than seven days, and if I'm prescribing patients for pain medicine for weeks on weeks on end, there's potential that I could be addicting patients," explained Dr. Goldberg.
The surgeon of 14 years explained how he first learned about pain management.
"Since I was in medical school in the 1990s, we started to have this push in medicine that pain was kind of a fifth vital sign, so we would ask people what their blood pressure was and then we'd say what is your pain?... And I grew up in an era where if people were in pain, that needed to be dealt with immediately and people weren't allowed to have discomfort," Dr. Goldberg said.
Dr. Goldberg still wants to do that only in a much safer and non-addictive way, especially with what he is seeing in patients these days.
"Now we are seeing a lot of patients who are preoperatively already using opioids and they're already using narcotics. ... We can predict that two-thirds of out patients who take narcotics prior to surgery will take narcotics after surgery, so we are not doing a great job of solving patients' addictive tendencies by doing an operation on them," said Dr. Goldberg.