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Opioid Prescribing Practices of Orthopaedic Surgeons

Results of a National Survey

Raneses, Eli, MPH; Secrist, Eric S., MD; Freedman, Kevin B., MD, MSCE; Sohn, David H., MD, JD; Fleeter, Thomas B., MD; Aland, Christopher M., MD

JAAOS - Journal of the American Academy of Orthopaedic Surgeons: February 15, 2019 - Volume 27 - Issue 4 - p e166–e172
doi: 10.5435/JAAOS-D-16-00750
Research Article

Introduction: Opioids are widely used after orthopaedic procedures. Nonmedical opioid use is a growing public health issue.

Methods: An anonymous online survey was distributed by e-mail to the orthopaedic societies of all 50 states and several large private practices to assess practicing orthopaedic surgeons' opioid prescribing practices.

Results: A total of 555 orthopaedic surgeons practicing in 37 states responded. The most commonly prescribed opioid for both teenagers and adults was hydrocodone/acetaminophen. Of note, 42.3% reported that a patient they have prescribed opioids for developed an opioid dependency, whereas 35.3% do not believe that opioid use is a problem in their practice. Of note, 30.3% reported prescribing refills, and factors significantly associated with increased prescribing of refills included a greater number of years in practice (P < 0.001) and practicing in a suburban rather than an urban or rural environment (P = 0.03).

Conclusion: Orthopaedic surgeons rarely prescribe any refills, tend to prescribe less opioids to teenagers than adults, and prescribe fairly uniformly for patients who are treated nonsurgically or undergo minor or arthroscopic surgery. They exhibit considerable variation in prescribing for fractures and major procedures.

From the Rothman Institute Orthopaedics (Mr. Raneses, Dr. Freedman, and Dr. Aland), Thomas Jefferson University, Atrium Health, Charlotte, NC (Dr. Secrist), the University of Toledo Medical Center, Toledo, OH (Dr. Sohn), and the Town Center Orthopaedic Associates, Reston, VA (Dr. Fleeter).

Correspondence to Dr. Aland:

Dr. Freedman or an immediate family member is a member of a speakers' bureau or has made paid presentations on behalf of Genzyme and serves as a paid consultant to DePuy. Dr. Aland or an immediate family member has stock or stock options held in ArthroCare and Johnson & Johnson and serves as a board member, owner, officer, or committee member of the Arthroscopy Association of North America. None of the following authors or any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Mr. Raneses, Mr. Secrist, Dr. Sohn, and Dr. Fleeter.

© 2019 by American Academy of Orthopaedic Surgeons
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