Dr. Isaac Karikari: Changing attitudes toward opioids and how physicians can drive change

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Isaac Karikari, MD, is an associate professor of neurosurgery and director of the adult neurosurgery spine fellowship at Duke University Medical Center in Durham, N.C.

In August, SpineLine, the primary publication for North American Spine Society members recognized Dr. Karikari in its '20 Under 40' list of top spine surgeons for 2019.

Here, Dr. Karikari provides insight into his patient population's changing attitude toward opioids and what physicians can do to help tackle the opioid crisis.

Question: How have your patients' perceptions of opioids changed in the last five years?

Dr. Isaac Karikari: Patients are becoming increasingly aware of the national epidemic of opioid abuse. This awareness has helped set realistic expectations for patients during the perioperative period and, in general, I believe patients are becoming more receptive to non-opioid alternatives for pain control.

Q: What do you think has been the primary factor contributing to changes in patients' attitudes toward opioids?

IK: National and physician driven education has been the principal driver for this change in my opinion.

Q: How do you see opioid prescription developing in the U.S. in the future?

IK: I envision more stringent regulations making it more difficult to prescribe large quantities of opioids and efforts to decrease the duration of opioid exposure. It is my hope that less reliance on opioids for pain control will drive enthusiasm and support for research into non-opioid alternatives or opioids with no abuse or addictive potential.

Q: What are your theories as a physician to help tackle the opioid crisis? 

IK: I believe it begins with education of both physicians and patients alike. We need to continue to strive toward developing efficacious alternatives for pain control to lessen our over-reliance on opioids. I strongly believe the physical experience of pain is heavily influenced by other factors such as psychological, social and cultural factors. Thus, a multidisciplinary approach to personalize each patient's pain management will undoubtedly help with this effort.

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