Kentucky Doc Spring 2016 - Page 12

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