Moshfegh and colleagues reviewed data from the IBM database in patients between 18-64 years of age recently diagnosed with an orthopedic problem.
They found the risk for chronic opioid use/ abuse was highest in patients with:
- multiple sites of pain (1.5%)
- low back pain (1.4%)
- neck pain (.43%).
The authors suggest limiting use of opioids in patients who have these risk factors and using other medications (Ibuprofen, Naprosyn).
As a spine provider, I take care of low back pain and neck pain daily. Often, these patients have multiple body parts that hurt. This patient group is at increased risk of long-term opioid use and possible abuse.
While philosophically, decreasing pain is a goal, helping the patient is the main objective.
As times have changed, saying “NO” to requests for opioids has become more common. In certain patients, saying “no” is the right thing to do.