Articles: opioid.
-
The rate of overdose deaths has increased dramatically over the past 2 decades. Recently, efforts have been made to expand access to medications for opioid use disorder, such as buprenorphine, by removing X-waiver training requirements. ⋯ We argue that while buprenorphine diversion is not to be condoned, the benefits of such actions greatly outweigh the harms. Thus, criminalization of diverted buprenorphine represents a dangerous and wasteful response that threatens the progress made through expanded access to this lifesaving medication.
-
Anesthesia and analgesia · Mar 2022
The Perioperative Use of Benzodiazepines for Major Orthopedic Surgery in the United States.
Despite numerous indications for perioperative benzodiazepine use, associated risks may be exacerbated in elderly and comorbid patients. In the absence of national utilization data, we aimed to describe utilization patterns using national claims data from total hip/knee arthroplasty patients (THA/TKA), an increasingly older and vulnerable surgical population. ⋯ Based on a representative sample, 4 of 5 patients undergoing major orthopedic surgery in the United States receive benzodiazepines perioperatively, despite concerns for delirium and delayed postoperative neurocognitive recovery. Notably, benzodiazepine utilization was coupled with substantially increased opioid use, which may project implications for perioperative pain management.
-
Observational Study
Understanding the Natural History of Postoperative Pain and Patient-Reported Opioid Consumption After Elective Spine and Nerve Surgeries With an Automated Text Messaging System.
There is a gap in understanding how to ensure opioid stewardship while managing postoperative neurosurgical pain. ⋯ Using real-time, patient-centered pain assessment and opioid consumption data will allow for the development of evidence-based opioid prescribing guidelines after spinal and nerve surgery.