Currently, patients in seven states can tell their physicians they don’t want to be treated with opioids in any health care setting, even during surgery. While unnecessary opioid exposure is a big reason behind the opioid epidemic in the U.S., we believe that non-opioid directives that allow patients to opt out of opioids in the operating room may lead to unexpected harms.
Non-opioid directives share some common features with advance directives, legally recognized documents that allow patients to list their preferences for what happens at the end of life. Both documents guide care based on the desires of the patient. Non-opioid directives are mandates that a patient must not receive opioids under any circumstances. Exceptions are rare.
