Editorial: The Opioid Epidemic and Orthopaedic Surgery—No Pain, Who Gains?

Excerpt

The available information in the lay press and medical journals about the opioid epidemic is both contradictory and confusing. One media outlet suggests the problem is both increasing [12] and decreasing [9], seemingly at the same time. A large federal healthcare agency claims pain should be considered the “5th Vital Sign” [6], even as The Joint Commission—which earlier had pushed for more-robust pain management—says it shouldn’t be a vital sign after all [3]. And the latest data from the Centers for Disease Control and Prevention note that while opioid prescribing decreased in 2015, overall it remains higher than it was in 1999 [10]. But some statistics can help to clarify the real scope of the problem. For example, the United States represents only 4.6% of the world’s population, but Americans consume 80% of the global opioid supply and 99% of the hydrocodone [18]. In 2015, more than 52,000 people in the United States died from drug overdoses, and some 15,000 of those overdoses involved a prescribed opioid [10]. The CDC reports that prescription-opioid abuse, dependence, and overdose costs the US economy an estimated USD 78.5 billion each year [10]. What seems clear enough is that the opioid epidemic is large, and that orthopaedic surgeons have been and are still a part of the problem. On the bright side, orthopaedic surgeons also can be a big part of the solution. …