A Vanderbilt physician researcher is highlighting that orthopaedic surgeons are among the highest prescribers of opioid pain medicine in the United States and calling on practitioners to exercise caution when prescribing the potentially addictive pain medicine.
A literature review published in the May issue of The Journal of the American Academy of Orthopaedic Surgeons reports that among all physicians, orthopaedic surgeons are the third-highest prescribers of opioids.
“The past few decades have seen an alarming rise in opioid use in the United States, and the negative consequences are dramatically increasing,” said Hassan Mir, M.D., MBA, associate professor of Orthopaedics and Rehabilitation, who co-authored the study. “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 after-effects for individual patients and for society at large.”
Primary care physicians and internal medicine physicians topped the list of opioid prescribers.
As a result of so many physicians prescribing opioids, some patients have started to build up a tolerance to the drugs, making them less effective and impacting outcomes for treatment of work-related injuries or orthopaedic procedures such as joint replacements and spine surgery.
Other problems have also arisen. The increased availability has resulted in an increase in the illegal sale or sharing of the medications and an increase in opioid addiction or abuse.
Brent Morris, M.D., a shoulder and elbow surgeon at the Lexington Clinic Orthopedics Sports Medicine Center in Kentucky who trained as an orthopaedic surgery resident at Vanderbilt, co-authored the study.
The new literature review points to the need for physicians to use a more comprehensive strategy to evaluate when to prescribe opioids, and when not to, the study’s authors said.
“Orthopaedic patients can experience a tremendous amount of pain with acute injuries and chronic conditions, and the treatment plan may involve opioid prescriptions for relief of discomfort,” Mir said. “A significant number of orthopaedic patients and their families are at risk for repercussions from opioid use. We must work together with all prescribers and patients to decrease the use of opioids for musculoskeletal pain.”
