The Opioid Epidemic and Orthopedic Outcomes: Implications and Strategies

Abstract

There has been a recent rise in efforts to recognize and curtail the detrimental effects of nontherapeutic opioid use. Diversion of prescribed opioids for nontherapeutic use has led to many unforeseen consequences at the individual and societal levels, and has led many to term our current state as an opioid epidemic. It is important to address the consequences of opioid use in the setting of both therapeutic and nontherapeutic use. The downside of nontherapeutic opioid use is very clear with a striking increase in addiction and unintentional overdose deaths in our country. The subtler features of the opioid epidemic are unexpected consequences of therapeutic opioid use. Perhaps in an effort to better identify and treat pain, opioids are increasingly prescribed without an awareness of the potential detrimental impact of therapeutic opioid usage. Recent studies have highlighted the negative consequences of preoperative opioid use. Therapeutic opioid use before orthopedic surgery is now recognized to be associated with worse clinical outcomes after surgery. This article addresses the disproportionate use of opioids in the United States, the role of physicians and orthopedic surgeons, individual and societal impacts, and some potential ways to address the opioid epidemic.