Saturday, May 9, 2015

The Unanticipated Consequences of Prescription Opioids

The over prescribing of prescription opioids, such as Vicodin (hydrocodone) and OxyContin (oxycodone), has lead to a crisis of epidemic proportions. Doctors turn to prescription opioids as a first line of defense in the treatment of pain when, in many cases, they should prescribe opioid painkillers after other avenues have been exhausted. It would seem that the opioid epidemic is not a problem exclusive to America, but when you consider the fact that Americans consume 99 percent of all hydrocodone prescribed worldwide, it would appear that the United States stands alone.

In fact, the United States consumes 80 percent of the global opioid supply, Science Daily reports. New research shows that, after primary care physicians and internists, orthopaedic surgeons are the largest prescribers of prescription opioids - which has created unanticipated consequences.

"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, MD, MBA, associate professor of orthopaedics and rehabilitation at Vanderbilt Orthopaedic Institute. "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."

The increased usage of opioids for orthopaedic pain management has led to:
  • 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.
  • Addiction and unintentional overdose deaths.
"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," says Dr. Mir. "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."

The findings were published in The Journal of the American Academy of Orthopaedic Surgeons.

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