12
doc • Spring 2016
Kentucky
Opioids and the management
Proud
to
of musculoskeletal
conditions
Partner
with You
By Brent J. Morris,
MD, Shoulder & Elbow
Surgeon, Lexington
Clinic Orthopedics Sports Medicine Center,
The Shoulder Center of
Kentucky
United States. The United States comprises
less than 5% of the world’s population yet
consumes nearly all of the world’s prescription opioid supply (80% of the global opioid
supply, including 99% of the global hydrocodone supply).1
Patient-reported pain in the outpatient
setting has remained relatively unchanged
over the last decade, yet there have been significant increases in opioid prescriptions for
pain.2 The increase in opioid prescriptions for
pain has not been met with similar increases
in nonopioid alternatives such as nonsteroidal anti-inflammatory drugs (NSAIDs) or
acetaminophen.2
The proliferation of opioid prescribing
has led to many unanticipated consequences.
Diversion of opioids for nontherapeutic
use has led to significant increases in opioid
addiction and unintentional overdose deaths.
Five Star Senior Living
Musculoskeletal conditions represent a
significant portion of patient
visits to priReferral
Guide
mary care providers in the United States.
Management of acute and chronic musculoskeletal conditions can be challenging for
both primary care providers and for specialty
providers. Opioid medications are used more
commonly to treat musculoskeletal conditions, including osteoarthritis. The expansion of indications for opioids has led to a significant increase in opioid prescribing in the
Opioid-related deaths are now more common
that heroin, cocaine, suicide, and motor vehicle related deaths.3 The unfortunate impact
of nontherapeutic opioid use is evident; however, the negative impact of therapeutic opioid use for the treatment of musculoskeletal
conditions is now being recognized as well.
Preoperative opioid use for patients with
knee osteoarthritis has been associated with
significantly worse outcome scores, increased
postoperative complications, and prolonged
recovery following total knee arthroplasty.4
Preoperative opioid use prior to spine surgery
has been associated with worse postoperative
outcomes, increased length of stay, increased
intraoperative and postoperative opioid
demand, and decreased opioid independence
one year after surgery.5-7
Similar results have been noted following total shoulder arthroplasty and reverse
Working with seniors each day, you know better
than anyone what they need to live healthy,
happy lives. We’re here to help.
Proud to
Partner
Working with seniors each day, you know better than anyone what they need to live healthy, happy
lives. We’re here to help.
with
You
If you know seniors who:
Five
Star
Senior
Living decline
• Are
lonely
or experiencing
Referral
• Live in Guide
environments that pose fall risks
• Often call for emergency assistance
• Mismanage medications
• Have frequent
If you know seniors who:
• Are lonely or experiencing decline
• Live in environments that pose fall risks
• Often call for emergency assistance
• Mismanage medications
• Have frequent exacerbations of chronic
diseases
• Appear disheveled or lack proper nutrition
• Could benefit from a warm, loving, engaging
senior living community
exacerbations
of chronic diseases
• Appear disheveled
oryour
lack
proper
nutrition
Call on
friends
at Five
Star Senior Living –
The Lafayette & Lexington Country Place
• Could benefit from
a warm, loving, engaging
With Independent Living, Personal Care, Skill Y