Opioids: Orthopedic Surgeons are Major Prescribers

New research indicates that orthopedic surgeons are the third highest prescribers of opioid prescriptions among physicians in the United States. The literature review, which appears in the May issue of The Journal of the American Academy of Orthopaedic Surgeons, found that this is resulting in a plethora of problems.

“The past few decades have seen an alarming rise in opioid use in the United States, and the negative consequences are dramatically increasing, ” says study co-author Hassan R. Mir, M.D., M.B.A., associate professor of orthopedics and rehabilitation at Vanderbilt Orthopaedic Institute, in the May 7, 2015 news release. “Management of pain is an important part of patient care; however, the increased usage of opioids for the treatment of pain has led to several unanticipated aftereffects for individual patients and for society at large.”

According to the authors, the increased usage of opioids for pain management has led to unanticipated consequences, including, patients building up tolerance to drugs; worse treatment outcomes for conditions including work-related musculoskeletal disorders, joint replacements and spine surgery; unlawful sale or sharing of opioid medications with others; and, when used inappropriately, addiction and unintentional overdose deaths can result.

Study co-author Brent J. Morris, M.D., a shoulder and elbow surgeon with the Lexington Clinic Orthopedics – Sports Medicine Center, says, “Physicians should aim to control pain and improve patient satisfaction while avoiding overprescribing opioids. A comprehensive strategy of risk assessment is needed to identify patients who may be at risk for opioid abuse. Objective measures including patient history, recognition of aberrant behavior, urine drug testing, state prescription drug—monitoring programs, and opioid risk-assessment screening tools may be necessary in select cases.”

Dr. Mir told OTW, “We should work on developing clinical practice guidelines and alternative multi-modal pain control regimens to help guide clinicians and patients on the control of musculoskeletal pain with fewer opioid medications.”