{
  "abstract": "The devastating opioid crisis in the USA has deep and multifaceted roots, closely linked to the healthcare system’s management of the “fifth vital sign”—pain. Prescribing providers have contributed to the crisis primarily through overprescribing opioids for pain management which exposed patients to addiction and caused enough overdose deaths to make it the leading cause of death in the USA. Significant attention has been brought to this issue and several national agencies, such as the Centers for Disease Control and Prevention in 2022, sought to provide guidelines to reduce opioid exposure, stressing utilization of multimodal therapies to mitigate opioid dependency.1 A Johns Hopkins Expert Panel, consisting of surgeons, pain specialists, and pharmacists, created recommendations to limit the number of tablets to 0–20 tablets for common uncomplicated general surgery, orthopedic, and gynecological surgeries. Interestingly, a consistent trend observed was that many of the patients who underwent those procedures voted for lower opioid amounts than the surgeons who performed them.2 Forward-thinking strategies have been implemented by individual institutions to address this problem. One group of emergency physicians altered the default opioid dose in their electronic medical record from “every 6 hours as needed” to “1 tablet”, which led to the reduction of prescriptions greater than 50 Morphine Milligram Equivalent dose (MMED) from 46% to 1.6%.3 Another group developed an innovative perioperative pain program at Johns Hopkins with multidisciplinary teams including acute and chronic pain specialists, psychiatrists, and physical medicine services to address postoperative pain regimen with greater success than traditional approaches.4 Although there are many encouraging articles presenting small victories, there is very limited evidence regarding a national trend.",
  "authors": [
    {
      "affiliations": [
        "Anesthesiology, Johns Hopkins Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Marie Hanna"
    },
    {
      "affiliations": [
        "Anesthesiology, Johns Hopkins Medicine, Baltimore, Maryland, USA"
      ],
      "name": "Shruti Sudhakar"
    }
  ],
  "title": "Are we judicious enough regarding usage of opioids for traumatic brain injury?",
  "uid": "d20e6c2c-53b5-5748-a3bd-490ef8fe42fb"
}