Pharmacists Guide Surgical Patients Through Safer Postoperative Pain Management | PPA Annual Conference

In operating rooms and recovery wards across the country, a quiet shift is underway in how postsurgical pain is treated, and pharmacists are emerging as central players in that change. For decades, opioids were the default answer to postoperative pain, a practice that helped fuel a nationwide crisis. Today, synthetic opioids continue to drive a devastating death toll. Health systems are rethinking pain management from the ground up, and pharmacists are helping to lead the move toward safer, nonopioid strategies.

Michelle Jo, PharmD, postdoctoral medical affairs fellow at St. Joseph’s University, explains how pharmacists are involved at every step of the surgical journey—from preoperative education through discharge and follow-up—to improve pain control while minimizing opioid use. Before surgery, pharmacists can prepare patients for what postoperative pain is likely to feel like, explain ambulation and recovery expectations, and review planned medications to promote safe use in what can be a disorienting time. After surgery, they perform detailed medication reconciliation, ensure that discharge prescriptions align with evidence-based multimodal pain plans, and guard against hidden risks such as duplicate acetaminophen in combination products.

Their role does not end at the hospital door. Pharmacists help simplify complex regimens, deprescribe unnecessary medications, and support smooth transitions from hospital to home. They monitor for tolerability, adverse events, suboptimal pain control, and patient-specific factors like renal and hepatic function or drug–drug interactions. Working alongside surgeons, anesthesiologists, and primary care teams, pharmacists advocate for guideline-aligned nonopioid therapies, select appropriate nonsteroidal anti-inflammatory drugs and adjuncts, and support opioid stewardship by keeping opioid courses as short and effective as possible. As our understanding of pain pathways evolves and new treatments emerge, pharmacists are uniquely positioned to steer both patients and providers toward safer, evidence-based recovery.

“Pharmacists are really important because they play a central and also increasingly visible role in helping patients manage their pain after surgery,” Jo said. “Postoperative pain is extremely complex, like we know patients benefit from a health care professional who can easily translate the mechanisms, guidelines, [and] real-world barriers into a practical plan.”