According to a study in the orthopaedic journal, JBJS, 5.3% of patients who underwent orthopedic surgery were still taking narcotics one year after surgery. These are patients who were not chronic opiate users before surgery. The highest rates were found after revision spine surgery.
In an accompanying editorial, “Does Orthopaedic Surgery Often Cause New Chronic Opioid Use? (https://bit.ly/2Ys4ZQ5)” Jacques T. YaDeau, M.D., Ph.D., who is an anesthesiologist at HSS, wrote that this study should have an impact on the informed consent process. Certainly, we have started to talk to patients a lot more about the risks of taking pain medicine for a prolonged period. I do think for high-risk procedures we should alert patients before surgery for a better possible outcome.
Managing pain is complicated. As doctors, we don’t like to see patients in pain, and we were trained to give medication to reduce pain. The crisis in America of drug addiction has lead to being very restrictive in how many pills are prescribed and how often. However, we need more research to find out which patients are at the highest risk and programs to alleviate their pain without prolonged medication.