Knee Surgery Linked to Post Surgery Narcotic Addiction in New Study

By Chris Centeno, MD /

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knee surgery narcotic addiction

Yesterday I blogged on an example of a guy who should have needed shoulder surgery and dodged the bullet by undergoing an ultraprecise injection of his own stem cells. He knew from my Regenexx ProActive book that surgery for a painful joint was often a slippery slope toward inactivity. Now a new study argues that patients who opt for surgery also dramatically increase their risk of becoming addicted to narcotics.

America Has a Narcotics Problem

I’ve blogged before about the scary OxyContin rep who used to haunt the medication closet in our office. In the pharma melee of convincing family and other doctors to prescribe more narcotics for pain and the diversion that was sure to follow, OxyContin and other prescription narcotics have become a national killer. This is from the CDC:

“Overdose deaths involving prescription opioids have quadrupled since 1999,1  and so have sales of these prescription drugs.2 From 1999 to 2014, more than 165,000 people have died in the U.S. from overdoses related to prescription opioids.1

Opioid prescribing continues to fuel the epidemic. Today, at least half of all U.S. opioid overdose deaths involve a prescription opioid.1  In 2014, more than 14,000 people died from overdoses involving prescription opioids.”

The New Study on Post Surgery Narcotic Addiction

In the new study, researchers looked at more than 18 million patients who had many different types of common surgeries and adjusted for various factors that could make them more susceptible to narcotic addiction. Which procedure produced the highest risk? Patients who had knee surgery were five times more likely to develop a post surgery narcotic addiction, to medications like hydrocodone and oxycodone, than a control group who didn’t undergo knee surgery!

Why Is This Happening?

It’s frankly not hard to see why something like this fits with what we know about knee surgery. After all, the two most common knee surgeries are knee replacement and partial meniscectomy (“fixing” a torn meniscus). Here’s what we know from recent high-level research studies about whether these procedures work at all:

So patients in pain are walking into a procedure that is either minimally effective or not effective. They also believe the procedure is the definitive answer to their knee pain. When it doesn’t work, they either get a second procedure to try and make it work (which often makes things still worse) or they find a way to stay on their post-op narcotics. Either way, getting hooked on narcotics becomes more likely.

The upshot? It’s not surprising to me that operating on knees dramatically increases the risk of a post surgery narcotic addiction. With our epidemic of addiction and deaths due to narcotics, hopefully policy makers who determine what gets covered by insurance and national health programs, like Medicare, take note and rightsize reimbursement for common knee surgeries to match their lackluster outcomes and, now, narcotic-addiction potential.

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4 thoughts on “Knee Surgery Linked to Post Surgery Narcotic Addiction in New Study

  1. Dr. harvey gilbert

    Is single injection knee PRP proven to relieve pain significantly with out major disruption of life style. 76 year old patients who have stiffness, swelling and lessened mobility. Do you have any published articles in the medical literature showing its benefit?

    1. Regenexx Team Post author

      Dr. Gilbert,

      One of the many benefits of autologous percutaneous treatment is lack of major lifestyle disruption. However, the effectiveness of a single PRP injection depends on many variables. 1. The type of PRP, as generic PRP can cause problematic inflammation. 2. What is being treated and whether or not PRP is a good fit for the issue, ie arthritis, meniscus tear, ACL, LCL,PCL, Patellar tendon, tib-fib joint, quadriceps, etc. 3. Injection technique as a blind injection into the knee joint won’t do much. Please see: http://www.regenexx.com/explain-interventional-orthopedics/ and http://www.regenexx.com/prp-platelet-rich-plasma/ http://www.regenexx.com/prp-didnt-work/ and http://www.regenexx.com/what-is-prp/

  2. Michael Friedrichs

    When do you think alternative treatments are approved by the FDA and Medicare?

    1. Regenexx Team Post author

      Michael,
      Stem cell procedures neither require, nor are eligible for FDA approval. Like surgery, they need to be FDA Compliant, which all Regenexx procedures done in the U.S. are. There is no way to tell when Healthcare, whether government sponsored or private insurance, will begin to cover stem cell procedures. It will entail a paradigm shift which will need to sort through and detangle some hugely entrenched positions, and will presumably happen in stages. Please see: http://www.regenexx.com/blog/payola-in-medicine/ and http://www.regenexx.com/does-meniscus-repair-work/

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
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