Clinician Education & CME Credits
Visit HSS eAcademy for educational content on controlled substances, pain management, and chronic pain management.
Developing Strategies for Opioid Prescribing and Safe Pain Management
HSS Opioid Stewardship for Clinicians
The opioid crisis is one of the most pressing public health issues of our time. With overdose from prescribed opioids, heroin, and fentanyl a leading cause of accidental death in the United States, clinicians in all settings have urgently sought to avert the dangers of opioid overprescribing while safely managing pain.
At HSS, our surgeons, anesthesiologists, rheumatologists, physician assistants, nurse practitioners, pharmacists, and social workers have established a framework for assessing and treating opioid-naïve or -dependent patients, using prescription drug monitoring programs, and educating prescribers and patients on multimodal pain management.
Both pain and opioid-related side effects contribute to poor outcomes after surgery. On the other hand, multimodal analgesia can improve pain control, so it can directly affect the stress response. It also minimizes opioid requirements and opioid-related side effects to help facilitate recovery and better outcomes.
Research
As a multidisciplinary leader in musculoskeletal health, we are committed to sharing our expertise and collaborating with fellow clinicians as we all aim toward a new era of opioid stewardship.
pain or opioid-related presentations at conferences in June 2022-2023
active IRB pain management or opioid studies as of June 2023
pain management or opioid studies published in 2022-2023
Featured Projects and Studies
- Cannabidiol for Bilateral Total Knee Arthroplasty
- Genicular Nerve Blocks for Anterior Cruciate Ligament Surgery
- Pain Management and Safe Opioid Use
- Incorporating Acupuncture into ERAS for Ambulatory Total Hip Replacement (THR) Surgery
Recently completed pilot study: Oral Ketamine for postoperative pain and opioid reduction
View our Publications
- Tramadol prescribed at discharge is associated with lower odds of chronic opioid use after elective total joint arthroplasty. PMID: 35760515
- Opioid sparing effects of intravenous and oral acetaminophen in hip fracture patients: A population-based study. PMID: 36758393
- Buprenorphine for chronic pain treatment and elective orthopaedic surgery: a US national database analysis. PMID: 36566125
- Patients Undergoing Primary, Cementless TKA had Similar Pain, Opioid Utilization, and Functional Outcomes Compared to Matched Patients With Cemented Fixation. PMID: 37142071
- Preoperative cannabis use does not increase opioid utilization following primary total hip arthroplasty in a propensity matched analysis. PMID: 36129515
- Patient perceptions of pain management and opioid use prior to hip arthroplasty. PMID:36683303
The Starr Foundation Grant
In 2019, HSS received a $3 million grant from the Starr Foundation to establish the C.V. Starr Endowed Chair in Pain Management. This grant has enhanced existing pain management studies and funded new studies, expediting the translation of research findings into practice, improving safe prescribing practices, and exploring alternatives to opioids.
Seth A. Waldman, MD, Chairman of the HSS Controlled Substances Committee and Advisor of Opioid Prescribing Practices at HSS, is the inaugural holder of the chair. The grant funds a full-time PhD researcher, Alexandra Sideris, PhD, who is dedicated to opioid and pain management topics.
Some highlights of work conducted with this grant include:
- Inpatient and outpatient registries as pain and opioid informatics tools for research and QA/PI, as well as predictive analytics.
- An opioid tapering tool incorporated into Epic for discharge prescriptions.
- A survey study assessing opioid prescribing and tapering instructions.
- Optimizations to further characterize high-risk patients for risk stratification.
- HSS-wide documentation of opioid use/controlled substances from all surgical patients.
The Pain Prevention Research Center (PPRC)
Founded in 2023, The Pain Prevention Research Center (PPRC) at HSS is unique in its focus and commitment to studying the prevention of pain and associated deleterious outcomes. There are limited effective and safe treatments for chronic pain. Most treatments are only modestly effective for a subset of people, and efforts to develop novel pain treatments have been largely unsuccessful. Given the prevalence of chronic pain, as well as its significant personal and societal cost and immense complexity, the most promising approach may be in its prevention.
Goals of the Center:
- Identify and apply innovative approaches to prevent acute and chronic pain.
- Identify, conduct, and disseminate high-quality research on the prevention of acute and chronic pain and its adverse consequences.
- Expedite the development of effective and safe therapies for those who suffer from chronic pain
Highlights
Pain Research at ESRA 2023
At the 6th World Congress on Regional Anaesthesia & Pain Medicine, HSS presents new pain-related database registries.
Acupuncture During Orthopedic Surgery
Dr. Stephanie Cheng discusses her award-winning study about how intraoperative acupuncture can reduce pain and opioid use after TKA.
The U.S. Opioid Epidemic: A Growing Crisis
Dr. Seth Waldman, Advisor for Opioid Prescribing Practices at HSS, speaks as a panelist on an ethics panel discussion at Weill Cornell Medicine.
Novel Opioid Tapering Tool in the EHR
Presented at ESRA 2022: Personalized opioid tapering plans can be automated with EHR functionality.
Opioid Topics in the News
- Opioid Alternatives Face an Uphill Battle Against Insurers and Doctors
- Liposomal bupivacaine may augment pain management for spinal fusion
- HSS STUDY: KETAMINE + ASPIRIN FOR PAIN MANAGEMENT
- HSS Opioid Stewardship Initiatives: Tackling the Opioid Epidemic from Every Angle
- Novel Nerve Block Combination Decreases Opioid Use, Enables Earlier PACU Discharge Times After Hip Arthroscopy
- Novel Combination of Oral Ketamine and Aspirin Is Safe Form of Pain Medication after Total Knee Replacement Surgery
- Everything You Should Know About Allodynia
- Duloxetine Cuts Opioid Use After Total Knee Arthroplasty
- Is the Goal to Eliminate Opioids Altogether? Not So Fast …
- Knowledge Gaps on Opioid Use and Pain Relief After Surgery Offer Opportunities for Improving Patient Education
- Study Identifies Risk Factors for Pediatric Opioid Dependence After Surgery
- HSS Researchers Find Duloxetine May Reduce Opioid Use and Improve Pain Management After Total Knee Replacement
- HSS presents new research at 2021 ASRA Annual Meeting
- Opioids offer minimal benefit to pain, function in OA, no aid to QoL
- Length of Use of Post-op Opioids Should Vary by Procedure
- Less Pain, Reduced Need for Opioids
- How to Address Opioid Abuse with Patients
- HSS Receives $3 Million Grant from The Starr Foundation
- Opioid Management: How HSS Rises to the Challenge
- How Hospital for Special Surgery prescribed 500K fewer opioid pills in 18 months
- Intravenous ketorolac substantially reduces opioid use after fusion
- HSS Controlled Substances Task Force Accomplishments: An Update
- What Happens To The 25% Leftover Opioid Prescriptions?
- Hospital for Special Surgery sees results from opioid task force
- Orthopedic surgery trainees are rarely trained in opioid prescribing
- Opioid consumption patterns after lumbar microdiscectomy or decompression
- Clinician-healthcare administrator partnerships: Effective treatment for opioid epidemic
- Regarding Opioids in Spine Surgery Physician Education Is Critical
- HSS Orthopedic Surgeons Addressing Opioid Epidemic Head On
- Training the Prescriber: An Institutional Effort to Reduce the Amount of Opioids Prescribed Following Lumbar Surgery
- Is Opioid-Free Total Joint Arthroplasty Realistic? A Review of Regional and Multimodal Analgesia for TJA
- Meditation may help chronic pain sufferers cut back on opioids, study finds
- Multimodal Approach for Obstructive Sleep Apnea Reduced Post-op Opioids and Complications
- Toward Opioid-Free Surgery
- Hand Surgery Study: Education Curbs Opioid Prescribing
- Local Anesthetic Fails to Curb In-Hospital Opioid Use
- Intravenous Acetaminophen May Not Lower Opioid Use in Spine Patients
- Managing Pain With Fewer Opioids After Joint Replacement
- Opioid Safety: What Every Older Adult Needs to Know
- Multimodal Pain Relief Strategy Preferable to Opioids Alone
- Physician Education and Guidelines Lead to Big Drop in Opioids Prescribed after Ambulatory Hand Surgery
- Multimodal Analgesia Reduces Opioids, Complications After Surgery
- Amid Opioid Crisis, A New Approach To Pain Management
Back to Opioid Stewardship