From the Department of Orthopaedic Surgery and Rehabilitation, University of Texas Medical Branch at Galveston, Galveston, TX (Dr. Hagedorn and Dr. Danilevich), and the Department of Orthopaedic Surgery, McGovern School of Medicine, University of Texas Health Science Center Houston, Houston, TX (Dr. Gary).
J Am Acad Orthop Surg. 2019 Sep 15;27(18):e831-e837. doi: 10.5435/JAAOS-D-18-00438.
On October 26, 2017, US president, Donald J. Trump, declared the opioid epidemic a national public health emergency. This declaration opened the door to government funding for programs geared toward studying and treating opioid addiction; however, part of the responsibility to slow the epidemic falls on physicians. Orthopaedic surgeons prescribed the third-highest number of narcotic prescriptions among all physician groups, and therefore, they have a major role to play in decreasing the use of opioids. Although restricting prescriptions is part of the solution, orthopaedic surgeries are often painful, and opioid medications, along with other multimodal nonopioid medications, allow patients to control pain and improve function, especially in the short term. Therefore, to successfully manage pain and opioid prescriptions, orthopaedic surgeons should know the basic science behind these powerful medications. Understanding the basic mechanism of action of opioid and nonopioid medication classes, knowing what oral morphine equivalent are, and knowing which nonopioid drugs can amplify or weaken the potency of opioids will help orthopaedic surgeons become more informed prescribers and leaders in helping control the opioid epidemic.
2017 年 10 月 26 日，美国总统唐纳德·J·特朗普宣布阿片类药物泛滥是全国性公共卫生紧急事件。这一声明为旨在研究和治疗阿片类药物成瘾的项目提供了政府资金；然而，减缓这一流行的部分责任落在了医生身上。整形外科医生开出的麻醉性处方在所有医生群体中排名第三，因此，他们在减少阿片类药物的使用方面发挥着重要作用。尽管限制处方是解决方案的一部分，但整形外科手术往往很痛苦，阿片类药物和其他多种非阿片类药物可以帮助患者控制疼痛和改善功能，尤其是在短期内。因此，为了成功管理疼痛和阿片类药物处方，整形外科医生应该了解这些强效药物背后的基本科学原理。了解阿片类药物和非阿片类药物类别的基本作用机制，了解什么是口服吗啡等效物，以及了解哪些非阿片类药物可以增强或减弱阿片类药物的效力，将有助于整形外科医生成为更有见识的处方者和领导者，帮助控制阿片类药物泛滥。
