Effect of opioid dependence or abuse on opioid utilization after shoulder arthroplasty

Berglund, Derek D.; Rosas, Samuel; Kurowicki, Jennifer; Mijic, Dragomir; Levy, Jonathan C.

doi:10.5312/wjo.v9.i8.105

Cited by 24 publications

(9 citation statements)

References 14 publications

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“… 2 , 13 , 16 , 17 , 18 Furthermore, it was found that the majority of orthopedic subspecialties have been overprescribing to patients and recent studies have shown that providing disposal mechanisms for opioids can eliminate them from circulation. 3 , 9 , 20 , 21 , 23 Our study shows when patients were asked to check all that apply regarding storage and disposal of prescription narcotic medications, the responses were very widespread, Figure 3 a and b, reinforcing the gap of education on proper disposal mechanisms that can be addressed.…”

Section: Discussionmentioning

confidence: 89%

What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

Sabesan¹,

Dawoud²,

Chatha³

et al. 2021

JSES International

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Background There is an increasing need to understand what barriers are present to reduce opioid consumption in orthopedic practice. The purpose of this study was to better understand patient perceptions and understanding of opioid use after shoulder surgery. Methods Eighty-five patients who underwent shoulder surgery anonymously completed a 27-question survey adapted from the Maryland Public Opinion Survey on Opioids with additional demographics. The patients were asked about pain expectations after surgery, use of and access to opioids, opioid perceptions, and information provided regarding safe use, storage, and disposal of opioids. Results When asked about receiving information regarding opioids, only 36% of the patients reported having a conversation with their physician. When asked about appropriate use, 10% agree it is permissible to take more than the recommended dosage of prescription narcotics if they are feeling more pain than usual and 8.5% of the patients reported taking an opioid to get high multiple times in the past year. Furthermore, a majority agreed that opioids may lead to other substance abuse with 76% reporting the risk of harm to be great, and only 55% believing that opioid abuse may lead to overdose or death. Conclusions Surgeons need to be aware that most patients expect to have significant pain after shoulder surgery and expect to be given necessary and continued amounts of opioids. This highlights the need for better counseling and innovative nonopioid pain management protocols. At the institutional level, more effort needs to be made on providing adequate education and disposal mechanisms to help reduce diversion and misuse.

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Section: Discussionmentioning

confidence: 89%

What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

Sabesan¹,

Dawoud²,

Chatha³

et al. 2021

JSES International

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“… 33 The authors did, however, identify preoperative opioid use to be independently associated with persistent postoperative opioid use, consistent with a considerable and growing body of evidence in the orthopedic literature. 4 , 13 , 14 , 19 , 33 , 41 , 43 , 50 , 56 , 68 It is worth highlighting that only 16.9% of patients in our cohort reported preoperative narcotics use and that only 30.9% had opioid prescriptions in the 3 months before surgery according to Electronic-Florida Online Reporting of Controlled Substances Evaluation, which is slightly lower than the 36%-52% rate of preoperative opioid use cited in most studies 14 , 19 , 41 , 50 , 56 , 68 and may explain the parameter's low sensitivity for predicting postoperative opioid use in the present study.…”

Section: Discussionmentioning

confidence: 99%

“… 18 , 32 , 45 , 52 , 61 In the present literature, considerable evidence suggests that preoperative opioid consumption, abuse, or dependence is predictive of increased opioid consumption, prolonged use, and dependence perioperatively and postoperatively ( Table I ). 4 , 13 , 14 , 19 , 39 , 41 , 42 , 43 , 47 , 50 , 52 , 56 , 68 Preoperative opioid use has also been linked to worse clinical outcomes and lower rates of patient satisfaction. 12 , 49 , 63 Sabesan et al found that, compared to other pathologies, use of a reverse shoulder arthroplasty after a proximal humerus fracture was associated with an increased postoperative opioid dependence, and Jildeh et al found specific surgical factors including presence of biceps tenodesis and number of concomitant procedures significantly increased postoperative opioid demand.…”

mentioning

confidence: 99%

Application of risk assessment tools to predict opioid usage after shoulder surgery

Khoury¹,

Stephens²,

Brown³

et al. 2022

JSES International

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“…15 Other studies have also found similarly higher rates of depression and anxiety than those found in our study. 39 40 Berglund et al 41 using a Medicare database study identified that 2% (157 of 7,838) TSAs and 3% (206 of 6,920) of reverse TSAs had an opioid abuse or dependence. As this study only assessed one type of drugs, one would expect this prevalence to only increase when widened to the abuse of all illicit drugs.…”

Section: Discussionmentioning

confidence: 99%

Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

et al. 2020

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The purpose of this study was to compare the prevalence of mental health conditions among patients undergoing (1) primary total knee arthroplasty (pTKA), (2) septic revision total knee arthroplasty (rTKA), and (3) aseptic revision total knee arthroplasty (TKA). The State Inpatient Databases were queried for all TKAs from 2005 to 2014 yielding 563,144 patients. Patients were separated into the following cohorts: primary, septic revision, and aseptic revision. Diagnoses of any mental health condition and the following specific conditions were compared between the three cohorts: schizophrenia/delusion, bipolar disorder, depression/mood disorder, personality disorder, anxiety/somatic/dissociative disorder, eating disorders, attention deficit hyperactivity disorder /conduct/impulse control, alcohol abuse, and drug abuse. Throughout the study period, an increase in the prevalence of mental health conditions was observed in septic and aseptic revision patients. Overall, there was a significantly higher prevalence of mental health conditions in the septic revision cohort (22.7%) compared with the primary (17.8%, p < 0.001) and aseptic revision (20.0%, p < 0.001) cohorts. Specifically, septic revision TKA patients had a higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), drug abuse (p < 0.001), schizophrenia (p = 0.0007), and bipolar disorder (p < 0.001), compared with primary TKA patients. Additionally, there was a significantly higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), and drug abuse (p < 0.001) among septic revision patients compared with aseptic revision patients. Mental health conditions were significantly higher among septic revision patients. Alcohol and drug abuse were approximately twice as prevalent in septic revision patients compared with primary and aseptic revision patients. These findings should serve as a call to action for mental health support for patients suffering from PJI.

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Effect of opioid dependence or abuse on opioid utilization after shoulder arthroplasty

Cited by 24 publications

References 14 publications

What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

What do patients think about opioids? a survey of patient perceptions regarding pain control after shoulder surgery

Application of risk assessment tools to predict opioid usage after shoulder surgery

Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

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