Not a day goes by without hearing a news report, colleagues or lay people discuss the crisis that revolves around opioid drugs. What was once the solution to the problems of pain management has created a new health crisis. We now know that opioid drugs, while beneficial if strictly monitored can also create significant and sometimes deadly consequences.
As healthcare providers our goal was to help patients with their pain. There was no mal-intent; in fact, we were following best practice. We were being told that there was another vital sign that had not been managed appropriately and that it was now our responsibility to be sure that the smiley faces were happy and the pain scores were low. In the 1990s, new drugs were coming to the market that would assist in the management of the fifth vital sign. Simultaneously, the movement to have patients spend less time in hospitals with earlier and earlier discharges post-major orthopaedic and other procedures began to take hold.
It was stated in those days that if patients had pain, they would not become addicted. The concept of beginning the trajectory of addiction, abuse, or misuse never crossed the average healthcare provider's mind. Yet, here we are, two decades later and we clearly now see the impact this has had on individuals and society. It is now our responsibility to resolve this situation.
This issue was conceived in the spring of 2018 at the annual Editorial Board meeting for Orthopaedic Nursing. One of our annual discussions centers around what is happening in healthcare and in orthopaedics. Overwhelmingly, the discussion quickly centered around the opioid crisis and the responsibilities that we as healthcare journalists had in educating our peers on this topic. Possible topics were discussed and potential authors identified. The interest for this project was incredibly high and proceeded at record pace. I would like to thank the authors who wrote their manuscripts and completed their revisions swiftly; the reviewers who offered revision suggestions; and the editorial board for their commitment to this project.
This issue will not be the end to the discussion. Additional manuscripts will be published in the coming months as we continue to provide good resources to our readers. The solution starts with each one of us. Advocating for the use of limited opioid prescribing practices and the further development of multimodal pain management protocols is something that each of us can do. Consider joining your local community coalitions where multiple community sectors are partnering together in upstream activities to build prevention infrastructure, establish support systems to help people make healthy choices, and ensure that harm reduction strategies are in place for those in need. Let's all be part of the solution!