{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:13:41Z","timestamp":1780078421749,"version":"3.54.0"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T00:00:00Z","timestamp":1532563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>\n                    Opioid abuse and addiction is causing widespread devastation in communities across the\n                    <jats:styled-content style=\"fixed-case\">USA<\/jats:styled-content>\n                    and resulting in significant strain on our healthcare system. There is increasing evidence that prescribers are at least partly responsible for the opioid crisis because of overprescribing, a practice that developed from changes in policy and reimbursement structures. Surgeons, specifically, have been subject to scrutiny as \u2018adequate treatment\u2019 of post\u2010surgical pain is poorly defined and data suggest that many patients receive much larger opioid prescriptions than needed. The consequences of overprescribing include addiction and misuse, dispersion of opioids into the community, and possible potentiation of illicit drug\/heroin use. Several solutions to this crisis are currently being enacted with variable success, including Prescription Drug Monitoring Programmes, policy\u2010level interventions aimed to de\u2010incentivize overprescribing, limiting opioid exposures through Enhanced Recovery After Surgery protocols, and the novel idea of creating surgery\u2010 and\/or procedure\u2010specific prescribing guidelines. This problem is likely to require not one, but several potential solutions to reverse its trajectory. It is critical, however, that we as physicians and prescribers find a way to stop the needless overprescribing while still treating postoperative pain appropriately.\n                  <\/jats:p>","DOI":"10.1111\/bju.14446","type":"journal-article","created":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T04:06:26Z","timestamp":1528862786000},"page":"754-759","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":107,"title":["The United States opioid epidemic: a review of the surgeon's contribution to it and health policy initiatives"],"prefix":"10.1111","volume":"122","author":[{"given":"Katherine","family":"Theisen","sequence":"first","affiliation":[{"name":"Department of Urology University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Jacobs","sequence":"additional","affiliation":[{"name":"Department of Urology University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Macleod","sequence":"additional","affiliation":[{"name":"Department of Urology University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Davies","sequence":"additional","affiliation":[{"name":"Department of Urology University of Pittsburgh Medical Center Pittsburgh PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,26]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Prevention CfDCa National Center for Health Statistics. Multiple cause of Death 1999 \u2010 2016 on CDC WONDER Online Database released December 2017. Data are from the Multiple Cause of Death Files 1999\u20132016 as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Available at:http:\/\/wonder.cbc.gov\/mcd-icd10.html. Accessed February 2018."},{"key":"e_1_2_9_3_1","unstructured":"United Nations Office on Drugs and Crime.World Drug Report 2017. (ISBN: 978\u201092\u20101\u2010148291\u20101 eISBN: 978\u201092\u20101\u2010060623\u20103 United Nations publication Sales No. E.17.XI.6)."},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm655051e1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1601307"},{"key":"e_1_2_9_6_1","first-page":"1487","article-title":"Vital signs: overdoses of prescription opioid pain relievers \u2010 United States, 1999\u20102008","volume":"60","author":"Paulozzi LJ","year":"2011","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6626a4"},{"key":"e_1_2_9_8_1","unstructured":"TickH NielsenA PelletierKet\u00a0al.The Pain Task Force of the Academic Consortium for Integrative Medicine and Health. Evidence\u2010based Nonpharmacologic Strategies for Comprehensive Pain Care. A Consortium Pain Task Force White Paper 2017."},{"key":"e_1_2_9_9_1","volume-title":"The Joint Commission's Pain Standards: Origins and Evolution","year":"2017"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530230060032"},{"key":"e_1_2_9_11_1","unstructured":"Pain as the 5th Vital Sign Toolkit 2000. Available at:www.va.gov\/painmanagement\/docs\/toolkit.pdf. Accessed January 2018."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.284.4.423b"},{"key":"e_1_2_9_13_1","unstructured":"Centers for Medicare & Medicaid Services Baltimore MD. Available at:www.hcahpsonline.org. Accessed January 2018."},{"key":"e_1_2_9_14_1","first-page":"1","article-title":"CDC guideline for prescribing opioids for chronic pain\u2010United States, 2016","volume":"65","author":"Dowell D","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_9_15_1","first-page":"563","article-title":"Vital signs: variation among States in prescribing of opioid pain relievers and benzodiazepines\u2010United States, 2012","volume":"63","author":"Paulozzi LJ","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001993"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.3132"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.15.00614"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2016.08.016"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0147972"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000001904"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.1871"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2012.01.035"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517693665"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.09.088"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198001103020221"},{"key":"e_1_2_9_27_1","first-page":"425","article-title":"Long\u2010term analgesic use after low risk surgery: a retrospective cohort study","volume":"172","author":"Alam A","year":"2012","journal-title":"Intern Med"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0504"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000516"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1251"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6610a1"},{"key":"e_1_2_9_32_1","unstructured":"LipariR.How people obtain the prescription pain relievers they misuse. The CBHSQ Report: January 12 2017. Center for Behavioral Health Statistics and Quality Substance Abuse and Mental Health Services Administration Rockville MD."},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.2543"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.2147\/SAR.S24800"},{"key":"e_1_2_9_35_1","unstructured":"MuhuriPK DaviesMC.Associations of Nonmedical Pain Reliever Use and Initiation of Heroin Use in the United States. CBHSQ Data Review SAMHSA. 2013. Available at:http:\/\/www.samhsa.gov\/data\/. Accessed January 2018."},{"key":"e_1_2_9_36_1","unstructured":"ClarkT KreinerP StricklerG.Prescription drug monitoring programs: an assessment of the evidenfe for best practices. Philadelphia (PA): Pew Charitable Trusts 2012. Available at:http:\/\/www.pewtrusts.org\/~\/media\/assets\/0001\/pdmp_update_1312013.pdf. Accessed February 2018."},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2015.1673"},{"key":"e_1_2_9_38_1","first-page":"297","article-title":"State prescription drug monitoring programs and fatal drug overdoses","volume":"23","author":"Nam YH","year":"2017","journal-title":"Am J Manag Care"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1177\/003335491412900207"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2012.01327.x"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-016-0223-0"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-1037-x"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.0007-1323.2001.02044.x"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.07319.x"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.05.083"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000002510"},{"key":"e_1_2_9_47_1","doi-asserted-by":"crossref","unstructured":"DoleacJL MukherjeeA.The Moral Hazard of Lifesaving Innovations: Naloxone Access Opioid Abuse and Crime 2016. SSRN: Available at:https:\/\/ssrn.com\/abstract=3135264Accessed March 2018.","DOI":"10.2139\/ssrn.3135264"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002198"}],"container-title":["BJU International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fbju.14446","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/bju.14446","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T11:57:31Z","timestamp":1761739051000},"score":1,"resource":{"primary":{"URL":"https:\/\/bjui-journals.onlinelibrary.wiley.com\/doi\/10.1111\/bju.14446"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,26]]},"references-count":47,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/bju.14446"],"URL":"https:\/\/doi.org\/10.1111\/bju.14446","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.733445106.793556440","asserted-by":"object"}]},"ISSN":["1464-4096","1464-410X"],"issn-type":[{"value":"1464-4096","type":"print"},{"value":"1464-410X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,26]]},"assertion":[{"value":"2018-07-26","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}