TUESDAY, Could 14, 2019 (HealthDay Information) — As the US struggles with a painkiller-abuse epidemic, researchers have discovered that it is the amount of opioids prescribed after orthopedic surgical procedure, not the kind of opioid, that corresponds with long-term use.
“One of many frequent myths we encounter amongst clinicians is that some varieties of opioids, resembling hydromorphone, are extra harmful than others,” mentioned senior examine creator Dr. Marilyn Heng. She is an orthopedic surgeon in Boston.
“Our findings reveal how present beliefs concerning the mechanism of extended use could also be confounded,” Heng added in a information launch from the American Academy of Orthopaedic Surgeons.
For the examine, the investigators checked out practically 18,000 grownup sufferers who had surgical procedure for a traumatic musculoskeletal harm (resembling an arm or leg fracture). Not one of the sufferers had taken opioids within the six months earlier than the surgical procedure, and so they had no historical past of opioid abuse.
Extended opioid use (past 90 days) was related to the quantity of opioids prescribed when discharged from the hospital, somewhat than the opioid sort, the findings confirmed.
The researchers additionally discovered that prescribers usually did not bear in mind that totally different opioids have totally different strengths per milligram. This may end up in increased doses that put sufferers at elevated danger for extended use of the medicine.
Docs are inclined to concentrate on the variety of tablets, somewhat than the morphine milligram equal, Heng mentioned.
For instance, if energy is not taken into consideration when changing 20 oxycodone (OxyContin) tablets to 20 hydromorphone (Dilaudid) tablets, a affected person who’s given the hydromorphone tablets would obtain a dose enhance of greater than 142%, the examine authors defined.
Failure to account for opioid energy variations “usually results in the notion that sure opioid sorts seem like related to increased odds of issues, when the truth is, we’re prescribing far more of the stronger drug,” Heng mentioned within the information launch. This will result in dependency, she added.
The findings additionally present that orthopedic surgeons and sufferers mustn’t assume that one sort of opioid is “safer” than one other, the researchers mentioned.
The examine was printed Could 1 within the Journal of the American Academy of Orthopaedic Surgeons.
Orthopedic surgeons are the third highest prescribers of opioids amongst U.S. docs, in keeping with the researchers.
— Robert Preidt
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SOURCE: American Academy of Orthopaedic Surgeons, information launch, Could 9, 2019