Prescription opioids significantly contributed to a rise in drug-related fatalities in the past decade, and orthopedic surgeons are the third-highest prescribers of opioids among U.S. physicians, according to the National Survey on Drug Use and Health.
Eleven insights on opioid use in orthopedics:
1. A study published in JAMA showed that pairing lower opioid pill counts with education efforts decreased how many pills knee surgery patients took and how long they used the pills after surgery.
2. Preoperative opioid use increased adverse event rates after elective total joint arthroplasty, according to a study published in Pain Medicine.
3. A study published in The Journal of Medical Economies found that Exparel decreased opioid consumption and length of stay in hip replacement patients.
4. Orthopedic surgeon residency programs lack training on opioid-prescribing practices, Reuters reported based on a study in The American Journal of Surgery.
5. The quantity of opioids prescribed, not the type of opioid prescribed, affects postoperative dependency, according to research published in the Journal of the American Academy of Orthopaedic Surgeons.
6. Orthopedic surgeons prescribe more opioids than most other surgical specialties, Northwestern Memorial Hospital's David Kalainov, MD, said in an interview with Becker's Spine Review. Approximately 6 percent of patients who receive an opioid for the first time in association with a surgical procedure are still using a prescription opioid six months later, according to Dr. Kalainov. More than 70 percent of opioids prescribed after surgery go unused by the intended user.
7. The opioid-sparing enhanced recovery after surgery pathway for Medicare patients undergoing total joint replacement may promote early discharge and boost patient satisfaction, according to research presented at the American Academy of Orthopaedic Surgeons 2019 Annual Meeting in Las Vegas, March 12-16.
8. Large opioid prescriptions are unnecessary after total joint arthroplasty, according to a study in The Journal of Arthroplasty.
9. The Journal of Bone & Joint Surgery published a study outlining the benefits of text messaging communication with patients undergoing total joint arthroplasty. On average, patients who received perioperative education through a text-messaging bot stopped narcotic use 10 days earlier than patients who underwent traditional education.
10. Among osteoarthritis patients, preoperative opioid usage was highest among spine patients, according to a study in Arthritis Care & Research.
11. New York City-based Hospital for Special Surgery developed a mandatory narcotics-prescribing education program, which led to a significant decrease in excessive opioid prescriptions after ambulatory orthopedic surgery.