Despite all the articles, studies and billions of words written about opioid prescriptions, no one, until now, has documented the ACTUAL pattern of orthopedic physician opioid prescriptions.
And the credit for this essential work goes to an intrepid group of researchers at the Rothman Orthopaedic Institute who emailed anonymous surveys to the orthopedic societies in every state and several large private practices asking about opioid prescribing practices.
Not surprisingly, they hit a wall of resistance…and then they broke through.
Their work, “Opioid Prescribing Practices of Orthopaedic Surgeons,” appeared in the February 15, 2019 edition of the Journal of the American Academy of Orthopaedic Surgeons.
Christopher M. Aland, M.D., an orthopedic surgeon at Rothman Orthopaedic Institute in Philadelphia and co-author on the work, explained the rationale for the study to OTW, “The impetus for it was an article in Sports Illustrated that discussed how teens were getting hooked on prescription pain meds. At that time there was no published survey of actual prescribing practices, yet we knew that there were docs prescribing large numbers of pills. Our survey was quick and easy, but we did find a lot of resistance in obtaining the data—surprisingly.”
“From there, it took three years to get published, all the while reading many articles that were stating in their discussions that data such as ours did not exist or was insufficient in publication. Yet our manuscript sat awaiting a whole second set of peer review before getting published.”
“Most amazing was that we found that of doctors prescribing medications to adults, 22% gave greater that 30 pills for non-surgical treatment and 40% gave greater than 30 for minor surgery. In teens we found 24% non-op greater than 30 pills, and 32% minor surgery greater than 30.”
The authors found that “orthopedic surgeons rarely prescribe refills” and they “exhibit considerable variation in prescribing for fractures and major procedures.”
Dr. Aland told OTW, “Interestingly, in the final edit, the pill volumes were not included. Our intent was for prescribing surgeons to see the numbers of pills routinely prescribed and to self-evaluate their own practices regarding pill volume.”
“Fortunately, during the time from our initial survey (2015) to now, I think prescribing numbers have come down, largely due to the efforts of many in pointing out the issues with over-prescription. Finally, it was interesting that 47% of respondents were aware of patient abuse due to prescribing practices, but less than half of the practices had any protocol for opiate medication.”
