Opioids After Arthroscopy: We're Only Halfway Through the Crisis.

Abstract

The orthopaedic community and the general medical community have made progress in the quest to control opioid abuse, but perhaps we are only halfway there. Ample literature has defined the crisis, and governmental guidelines have attempted to curb overprescribing. The American Board of Orthopaedic Surgery now emphasizes the importance of continuing education on the issue, and the arthroscopic and related surgical literature shows the deleterious effect of preoperative narcotic consumption and the opportunity to achieve positive outcomes while limiting postoperative opioid prescriptions. A comprehensive solution requires identifying the problem, considering multimodal anesthesia, avoiding overprescribing, acknowledging that minimizing opioid use is not equivalent to undertreating pain, minimizing preoperative opioid use, managing patient expectations, and continuing to investigate the outcomes of pain management while limiting opioid prescriptions or forgoing opioids altogether.