Newly Published
Editorial  |   February 2020
Rational Perioperative Opioid Management in the Era of the Opioid Crisis
Author Notes
  • From the Department of Anesthesiology, Duke University School of Medicine, Durham, North Carolina (E.D.K.); Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois (M.J.A.); Anesthesiology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California (J.D.C.), and Department of Anesthesiology, Stanford University School of Medicine, Stanford, California (J.D.C.).
  • Accepted for publication January 6, 2020.
    Accepted for publication January 6, 2020.×
  • Michael M. Todd, M.D., served as Handling Editor for this article.
    Michael M. Todd, M.D., served as Handling Editor for this article.×
  • Correspondence: Address correspondence to Dr. Clark: djclark@stanford.edu
Article Information
Editorial / Pain Medicine / Pharmacology / Opioid
Editorial   |   February 2020
Rational Perioperative Opioid Management in the Era of the Opioid Crisis
Anesthesiology Newly Published on February 13, 2020. doi:https://doi.org/10.1097/ALN.0000000000003166
Anesthesiology Newly Published on February 13, 2020. doi:https://doi.org/10.1097/ALN.0000000000003166
Despite the thousands of years during which opioids have been used medicinally, the appropriate indications and usage for opioids, across medicine, remain incompletely defined. Having charged ahead with good intentions and strong opinions yet at times without strong data, practitioners are now grappling with serious missteps. The current opioid crisis is large and pervasive. The dimension—nearly 50,000 annual opioid-related deaths in the United States—is difficult to comprehend.1  The problem is no longer limited to the United States; Canada now faces similar problems, as does Europe.2  Rightly or wrongly, yet all with assumed good intent, practitioners, regulators, governments, courts, pharmacies, insurers, healthcare institutions, and others are responding. These responses are profoundly influencing medical practice in ways intended, unintended, and unexpected. One perhaps unintended consequence has been to germinate an “opioid phobia” in many quarters.