{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:41:47Z","timestamp":1787755307649,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,7,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Prescription of opioid analgesics is currently a common practice to relieve pain for musculoskeletal injuries in many regions of the world, especially in the United States and Canada. However, overprescription may underlie opioid misuse. Details on the utilization of prescribed opioids after nonoperative treatment of fractures and dislocations and whether consumption is related to injury location are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 1,513 consecutive patients in China who underwent nonoperative treatment of a fracture and\/or dislocation and who were prescribed opioids were studied over a 3-month period. Demographic information, alcohol consumption, smoking status, injury location, volume of prescription, and consumption patterns were recorded and were summarized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The mean number of opioid pills prescribed was 14.7, and the mean patient-reported number of pills consumed was 7.2. Overall, 152 patients (10.0%) reported taking no prescribed opioid analgesics, and 924 patients (61.1%) ceased their prescribed opioids prior to completing the regimen. Injury location, alcohol consumption, and type of fracture or dislocation were all significantly associated with the patient-reported number of opioid pills consumed (p &lt; 0.05). Patients with fracture and\/or dislocation of the wrist or forearm (9.4 pills for 3.8 days); ankle, tibia, or fibula (9.3 pills for 3.7 days); or elbow or humerus (9.1 pills for 3.7 days) used more opioid pills compared with patients with injuries at other locations (not exceeding 6.4 pills and 3 days). When compared with patients who had no, low, or moderate daily alcohol consumption, there was more opioid use in patients with high daily alcohol consumption (8.5 pills for 3.4 days) and those with very high daily alcohol consumption (11.3 pills for 4.7 days). Patients with a dislocation and\/or displaced fracture reported consuming 8.2 pills for 3.3 days, which was more than the consumption in patients with a nondisplaced fracture (6.2 pills for 2.5 days) and patients with an avulsion fracture (6.2 pills for 2.5 days).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Surgeons and patients should try to avoid opioids if possible after nonoperatively treated fractures and dislocations. If opioids are used, surgeons should prescribe the smallest dose for the shortest time after considering the injury location and type of fracture or dislocation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Prognostic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.01475","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T16:21:19Z","timestamp":1532017279000},"page":"1177-1183","source":"Crossref","is-referenced-by-count":7,"title":["A Prospective Evaluation of Patient-Reported Opioid Utilization After Nonoperative Treatment of Fractures and Dislocations"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9643-0790","authenticated-orcid":false,"given":"Hongyi","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People\u2019s Hospital, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8796-5515","authenticated-orcid":false,"given":"Yanchun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People\u2019s Hospital, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6404-602X","authenticated-orcid":false,"given":"Changqing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People\u2019s Hospital, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9770-5394","authenticated-orcid":false,"given":"Xianyou","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Shanghai Jiaotong University Affiliated Sixth People\u2019s Hospital, Shanghai, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,7,18]]},"reference":[{"issue":"3","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1056\/NEJMsa1406143","article-title":"Trends in opioid analgesic abuse and mortality in the United States","volume":"372","author":"Dart","year":"2015","journal-title":"N Engl J Med."},{"key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.ypmed.2015.04.003","article-title":"Prescription opioid abuse: problems and responses","volume":"80","author":"Compton","year":"2015","journal-title":"Prev Med."},{"issue":"Suppl 1","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1111\/pme.12904","article-title":"Prescription opioid misuse, abuse, morbidity, and mortality: balancing effective pain management and safety","volume":"16","author":"Cheatle","year":"2015","journal-title":"Pain Med."},{"issue":"2","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1080\/08897077.2011.630944","article-title":"Practices, perceptions, and concerns of primary care physicians about opioid dependence associated with the treatment of chronic pain","volume":"33","author":"Keller","year":"2012","journal-title":"Subst Abus."},{"issue":"2","key":"bib5-20230810","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1016\/j.juro.2010.09.088","article-title":"Overprescription of postoperative narcotics: a look at postoperative pain medication delivery, consumption and disposal in urological practice","volume":"185","author":"Bates","year":"2011","journal-title":"J Urol."},{"issue":"2","key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1056\/NEJM198001103020221","article-title":"Addiction rare in patients treated with narcotics","volume":"302","author":"Porter","year":"1980","journal-title":"N Engl J Med."},{"issue":"13","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1001\/jama.2011.401","article-title":"Characteristics of opioid prescriptions in 2009","volume":"305","author":"Volkow","year":"2011","journal-title":"JAMA."},{"issue":"2","key":"bib8-20230810","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/j.pain.2013.10.016","article-title":"Incidence and predictors of neck and widespread pain after motor vehicle collision among US litigants and nonlitigants","volume":"155","author":"McLean","year":"2014","journal-title":"Pain."},{"issue":"2","key":"bib9-20230810","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/j.pain.0000000000000756","article-title":"Persistent pain after motor vehicle collision: comparative effectiveness of opioids vs nonsteroidal antiinflammatory drugs prescribed from the emergency department-a propensity matched analysis","volume":"158","author":"Beaudoin","year":"2017","journal-title":"Pain."},{"issue":"20","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.2106\/JBJS.15.00614","article-title":"A prospective evaluation of opioid utilization after upper-extremity surgical procedures: identifying consumption patterns and determining prescribing guidelines","volume":"98","author":"Kim","year":"2016","journal-title":"J Bone Joint Surg Am."},{"issue":"2","key":"bib11-20230810","doi-asserted-by":"crossref","first-page":"355e","DOI":"10.1097\/01.prs.0000475788.52446.7b","article-title":"The use of opioid analgesics following common upper extremity surgical procedures: a national, population-based study","volume":"137","author":"Waljee","year":"2016","journal-title":"Plast Reconstr Surg."},{"issue":"3","key":"bib12-20230810","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1177\/0363546517693665","article-title":"Unused opioid pills after outpatient shoulder surgeries given current perioperative prescribing habits","volume":"45","author":"Kumar","year":"2017","journal-title":"Am J Sports Med."},{"issue":"3","key":"bib13-20230810","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1093\/eurpub\/ckx012","article-title":"Daily alcohol consumption and sickness absence in the GAZEL cohort","volume":"27","author":"Morois","year":"2017","journal-title":"Eur J Public Health."},{"issue":"10","key":"bib14-20230810","doi-asserted-by":"crossref","first-page":"2351","DOI":"10.1007\/s11999-017-5454-y","article-title":"Editorial: the opioid epidemic and orthopaedic surgery-no pain, who gains?","volume":"475","author":"Leopold","year":"2017","journal-title":"Clin Orthop Relat Res."},{"issue":"2","key":"bib15-20230810","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1197\/j.aem.2006.08.015","article-title":"The national trend in quality of emergency department pain management for long bone fractures","volume":"14","author":"Ritsema","year":"2007","journal-title":"Acad Emerg Med."},{"issue":"2","key":"bib16-20230810","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1111\/acem.12862","article-title":"Interpreting the National Hospital Ambulatory Medical Care Survey: United States emergency department opioid prescribing, 2006-2010","volume":"23","author":"Kea","year":"2016","journal-title":"Acad Emerg Med."},{"issue":"2","key":"bib17-20230810","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1056\/NEJMoa0903326","article-title":"Morphine use after combat injury in Iraq and post-traumatic stress disorder","volume":"362","author":"Holbrook","year":"2010","journal-title":"N Engl J Med."},{"issue":"5","key":"bib18-20230810","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1097\/01.psy.0000181276.49204.bb","article-title":"The development of persistent pain and psychological morbidity after motor vehicle collision: integrating the potential role of stress response systems into a biopsychosocial model","volume":"67","author":"McLean","year":"2005","journal-title":"Psychosom Med."},{"issue":"4","key":"bib19-20230810","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2106\/JBJS.K.01708","article-title":"Effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture: a randomized, controlled study","volume":"95","author":"Kang","year":"2013","journal-title":"J Bone Joint Surg Am."},{"issue":"22","key":"bib20-20230810","doi-asserted-by":"crossref","first-page":"1908","DOI":"10.2106\/JBJS.17.00149","article-title":"Pain relief after operative treatment of an extremity fracture: a noninferiority randomized controlled trial","volume":"99","author":"Helmerhorst","year":"2017","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib21-20230810","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3109\/15360288.2014.941132","article-title":"An examination of global and regional opioid consumption trends 1980-2011","volume":"28","author":"Hastie","year":"2014","journal-title":"J Pain Palliat Care Pharmacother."},{"issue":"116","key":"bib22-20230810","doi-asserted-by":"crossref","first-page":"116ra6","DOI":"10.1126\/scitranslmed.3002902","article-title":"Alcohol consumption induces endogenous opioid release in the human orbitofrontal cortex and nucleus accumbens","volume":"4","author":"Mitchell","year":"2012","journal-title":"Sci Transl Med."},{"issue":"5","key":"bib23-20230810","doi-asserted-by":"crossref","first-page":"e19372","DOI":"10.1371\/journal.pone.0019372","article-title":"Chronic ethanol consumption in rats produces opioid antinociceptive tolerance through inhibition of mu opioid receptor endocytosis","volume":"6","author":"He","year":"2011","journal-title":"PLoS One."},{"issue":"47","key":"bib24-20230810","doi-asserted-by":"crossref","first-page":"18540","DOI":"10.1523\/JNEUROSCI.3323-12.2013","article-title":"Mu-opioid stimulation in rat prefrontal cortex engages hypothalamic orexin\/hypocretin-containing neurons, and reveals dissociable roles of nucleus accumbens and hypothalamus in cortically driven feeding","volume":"33","author":"Mena","year":"2013","journal-title":"J Neurosci."},{"issue":"4","key":"bib25-20230810","doi-asserted-by":"crossref","first-page":"115","DOI":"10.3810\/pgm.2013.07.2684","article-title":"Risks, management, and monitoring of combination opioid, benzodiazepines, and\/or alcohol use","volume":"125","author":"Gudin","year":"2013","journal-title":"Postgrad Med."},{"issue":"1","key":"bib26-20230810","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jpain.2011.10.011","article-title":"The effects of ethanol on the bioavailability of oxymorphone extended-release tablets and oxymorphone crush-resistant extended-release tablets","volume":"13","author":"Fiske","year":"2012","journal-title":"J Pain."},{"issue":"7","key":"bib27-20230810","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.ejpain.2009.11.008","article-title":"Increased pain sensitivity in alcohol withdrawal syndrome","volume":"14","author":"Jochum","year":"2010","journal-title":"Eur J Pain."},{"issue":"2","key":"bib28-20230810","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s11920-014-0544-y","article-title":"Anxiety and substance use disorders: co-occurrence and clinical issues","volume":"17","author":"Vorspan","year":"2015","journal-title":"Curr Psychiatry Rep."},{"issue":"1","key":"bib29-20230810","doi-asserted-by":"crossref","first-page":"2","DOI":"10.3109\/15622975.2013.829585","article-title":"Glial abnormalities in substance use disorders and depression: does shared glutamatergic dysfunction contribute to comorbidity?","volume":"15","author":"Niciu","year":"2014","journal-title":"World J Biol Psychiatry."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/00004623-201807180-00002","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:40:56Z","timestamp":1787751656000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00004623-201807180-00002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,18]]},"references-count":29,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.17.01475","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,7,18]]}}}