16:10 PM

In Surgical Care, Opioid Use Is Complex

American College of Surgeons discusses the complexities of opioid use in orthopedics.

What is notable about prescription opioid use in the US today is that physicians, by and large, are doing better. The high tide of the epidemic saw excessive prescription rates—for example, from approximately 2 million opioid prescriptions to Medicare beneficiaries in 1991 to approximately 41.6 million such prescriptions in 2015.2 But those rates have now sharply decreased nationwide—in the case of Medicare beneficiaries, to approximately 19.1 million prescriptions in 2019.2 A 2024 Journal of the American College of Surgeons study showed that declines in rates of surgery-related opioid prescribing occurred in 81.6% of US counties between 2013 and 2017.3

This change has come as the pendulum of culture has swung from cavalier attitudes about opioids to deep concern. Across the US, healthcare centers have implemented programs meant to oversee, standardize, and reduce opioid prescribing. 

That said, few expect that opioid drugs will be eliminated from use. They are an effective, well-known, accessible pain management method, available in multiple fast-acting and extended-release formats, often at comparatively low costs—in other words, an option difficult to replace or forgo. Seth A. Waldman, MD, anesthesiologist and director of Pain Management at HSS, said, “Our goal is to make sure that we’re using opioids when they’re necessary at the lowest possible dose for as short a period of time as possible, but also to make sure that people aren’t avoiding opioids when they’re necessary—because they are. They’re important drugs, still.” 

Read the full article at facs.org.