Cited by 74Opioid Use Disorder TreatmentPain Management and Opioid UseAnesthesia and Pain Management

Leading the Way to Solutions to the Opioid Epidemic: AOA Critical Issues

Seymour, Rachel B., Ring, David, Higgins, Thomas, Hsu, Joseph R.·2017·Journal of Bone and Joint Surgery

Abstract

BACKGROUND: In the past 2 decades, overdoses and deaths from prescription opioids have reached epidemic proportions in the United States. The widespread use of opioids complicates management of the orthopaedic surgery patient in the acute and chronic settings. Orthopaedic surgeons are some of the top prescribers of opioids in the complex setting of chronic use, abuse, and diversion. METHODS: The literature regarding the basic science of pharmacologic options for pain management (e.g., opioids and nonsteroidal anti-inflammatory drugs), the impact of strategies on bone and soft-tissue healing, and pain relief are summarized as they relate to the management of orthopaedic injuries and conditions. Additionally, a section on designing solutions to address the current opioid crisis is presented. RESULTS: The mechanism of action of different classes of analgesic medications is discussed, as well as the basic scientific evidence regarding the impact of narcotic and nonnarcotic analgesic medications on bone-healing and on other organ systems. Differences between pain and nociception, various treatment strategies, and clinical comparisons of the effectiveness of various analgesics compared with opioids are summarized. Finally, options for addressing the opioid crisis, including the description of a large system-wide intervention to impact prescriber behavior at the point of care using health-information solutions, are presented. CONCLUSIONS: Orthopaedic leaders, armed with information and strategies, can help lead the way to solutions to the opioid epidemic in their respective communities, institutions, and subspecialty societies. Through leadership and education, orthopaedic surgeons can help shape the solution for this critical public health issue.

Integrity signals

Registry

Crossref · 10.2106/jbjs.17.00066

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114 of 114 references verified0 citation errors · 0 not checkable

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Authors
Seymour, R. B., Ring, D., Higgins, T., & Hsu, J. R.
Affiliations
  • Carolinas Medical Center (US)
  • The University of Texas at Austin (US)
  • University of Utah (US)
Venue
Journal of Bone and Joint Surgery
Published
2017-11-01
Volume
99
Issue
21
Pages
e113
ISSN
  • 0021-9355 (ISSN-L)
  • 1535-1386
OpenAlex
W2805853500
Cited by
74
References
116
Citations by year
2026: 3 · 2023: 6 · 2022: 9 · 2021: 13 · 2020: 22 · 2019: 18 · 2018: 3
FWCI
1.91
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Bone and Joint Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
  • Health Sciences › Medicine › Surgery › Anesthesia and Pain Management
Keywords
opioid epidemic, prescription opioid misuse, orthopedic surgery, pain management, analgesics, nonsteroidal anti-inflammatory drugs, bone regeneration, soft tissue healing, opioid overdose, prescriber behavior, health information systems
MeSH terms
Analgesics, Opioid, Humans, Musculoskeletal Diseases, Pain, Drug Prescriptions, United States, Analgesics, Non-Narcotic, Pain Management, Prescription Drug Misuse

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