Becker's ASC Review

88 OPIOID REDUCTION 'Terrifying': 2020 drug overdoses jump 30%, hit record 93,000 deaths By Gabrielle Masson D eaths from drug overdoses hit a record 93,000 in 2020, a nearly 30 percent jump from the prior year, according to a report from the CDC's National Center for Health Statistics. e provisional data accounts for U.S. deaths attributed to drug overdoses from November 2019 to November 2020. Over 21,000 more overdose deaths were reported in 2020 than in 2019, with an increase in overdose deaths reported in every state except South Dakota. Only Massachusetts, New Jersey and Alaska saw jumps less than 5 percent. "It's terrifying," Keith Humphreys, PhD, psy- chiatry professor at Stanford (Calif.) University and expert on addiction and drug policy, told e Washington Post. "It's the biggest increase in overdose deaths in the history of the U.S., it's the worst overdose crisis in the history of the U.S., and we're not making progress." e estimated number of overdose deaths reached 93,331 in 2020, according to the new data. More than 900,000 people have died of overdoses since the U.S. drug epidemic began about 1999, according to the CDC. Opioids, primarily illegal fentanyl, account for the majority of deaths, with overdose deaths involving opioids reaching 69,710 in 2020, up from 50,963 in 2019. e pandemic has stretched healthcare re- sources thin, complicating the drug epidemic. In 2020, anti-addiction medication was harder to obtain and users were more isolated, leading to additional overdoses because other people weren't nearby to call first responders or give naloxone, experts told the Post. Amid the COVID-19 pandemic, "we took our eye off the opioid epidemic," said Tami Mark, PhD, health economist and senior fellow at think tank RTI International. "When we weren't looking, it got horribly worse." n Cold treatment reduces opioid use, pain in total knee patients By Carly Behm S study found that preoperative cold treatment can reduce opioid intake and pain scores in total knee replacement patients during a six-week recovery period. The study, published in Arthroplasty Today, examined Pacira BioSci- ence's iovera system in total knee patients who stayed at a hospital. Io- vera treatment destroys tissue during surgery by applying freezing cold. Researchers compared one surgeon's total knee replacement patients at one center to a historical control group, according to a July 28 news release. Patients who received iovera treatment had 51 percent lower daily morphine milligram equivalents compared to the control group. Their mean and maximum pain scores also decreased compared to the control group. "Our analysis underscores the benefits of optimizing pain control in the perioperative period with the addition of iovera to a multimodal TKA pain protocol," lead author Joshua Urban, MD, said. "This approach allows patients to take fewer opioids during hospitalization and the six- week recovery period, reduce their hospital [length of stay], decrease readmission rate and face fewer postoperative complications." n 2-year results of sacroiliac joint implant show enhanced fusion, reduced opioid use By Alan Condon C linical trial results of the iFuse-3D implant system demonstrated significant improvements in sacroiliac joint pain, function and quality of life at 24 months. Five notes: 1. Results also indicated a notable reduction in opioid usage for pa- tients with sacroiliac joint pain — 59 percent at baseline to 18 percent at 24 months. 2. Three physical function tests — active straight leg raise, five times sit-to-stand and transitional timed up-and-go — showed statistically significant improvements from baseline. 3. Of treated sacroiliac joints in the study, 100 percent showed bone integration to the iFuse-3D implant surface on the sacral and iliac side, and 77 percent of joints showed bony bridging across the joint, ac- cording to a July 7 news release. 4. "Early results from radiographic analysis of implant bone integration and SI joint bony bridging indicate that the enhanced porous surface of the iFuse-3D implant combined with the fenestrated structural de- sign accelerates the rate of intraarticular fusion compared to the iFuse implant," said Vikas Patel, MD, principal investigator of the study. 5. IFuse, developed by sacropelvic company SI-Bone, has been evalu- ated in 90 peer-reviewed publications and has become the standard of care for sacroiliac joint fusion, according to the company. n

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