Even during this global pandemic, we have continued to prioritize addressing the opioid crisis,” began FDA Commissioner Stephen M. Hahn, M.D. after the FDA announced a new rule requiring labeling on opioid medication to recommend that healthcare professionals have a discussion with patients about the availability of naloxone to reverse the effects of an opioid overdose. Hahn continued, “Today’s action can help further raise awareness about this potentially life-saving treatment for individuals that may be at greater risk of an overdose and those in the community most likely to observe an overdose.”
“While most surgical specialties use opioids as part of post-operative pain management, orthopedic surgeons have historically prescribed opioids at a higher rate than other specialists. A 2020 study published in Surgery Open Science (“The opioid prescribing practices of surgeons: A comprehensive review of the 2015 claims to Medicare Part D”) investigated the opioid prescribing rates among specialties using 2015 Medicare Part D data. The researchers found that 48.6% of prescriptions written by orthopedic surgeons were for opioids. The rate of opioid vs other drug prescriptions was significantly higher for orthopedic surgeons than nearly all other surgical specialties.
As Hahn mentioned, steps to control the opioid crisis cannot relent due to concerns of the COVID-19 pandemic. Research and physician education are important parts of the effort to change prescription writing behavior. The August issue of The Spine Journal dedicated substantial space to studies attempting to shed light on the necessity of opioids, and how to anticipate and identify those most likely to succumb to addiction and opioid abuse. In addition to multiple studies on opioids, the issue’s editorial announced the publication of a supplement in the Journal of Bone and Joint Surgery containing research presented at a November 2019 Symposium on Pain Management Research.
The case series, “Opioid-free spine surgery: a prospective study of 244 consecutive cases by a single surgeon,” published by a group at Vanderbilt University Medical Center, tested whether opioids could be avoided completely for elective spine surgery.”
