Rate of Opioid Prescriptions for Patients With Acute Ankle Sprain
Authors: Fred T. Finney, Timothy D. Gossett, Hsou Mei Hu, Jennifer F. Waljee, Chad M. Brummett, David M. Walton, Paul G. Talusan, James R. Holmes
Journal: Annals of Internal Medicine (2019)

Letters17 September 2019Rate of Opioid Prescriptions for Patients With Acute Ankle SprainFred T. Finney, MD, Timothy D. Gossett, MD, Hsou Mei Hu, PhD, Jennifer F. Waljee, MD, MPH, Chad M. Brummett, MD, David M. Walton, MD, Paul G. Talusan, MD, and James R. Holmes, MDFred T. Finney, MDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), Timothy D. Gossett, MDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), Hsou Mei Hu, PhDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), Jennifer F. Waljee, MD, MPHUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), Chad M. Brummett, MDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), David M. Walton, MDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), Paul G. Talusan, MDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.), and James R. Holmes, MDUniversity of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M19-0679 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: The opioid epidemic is a result of overprescribing by practitioners and misuse and diversion of opioids. Ligamentous ankle injuries are common, with an estimated 1 sprain per day per 10 000 persons (1). Despite the frequency of this injury, treatment strategies remain broad and heterogeneous. Evidence-based treatment guidelines include cryotherapy, nonsteroidal anti-inflammatory drugs, and functional support and exercise (2). Although the role of opioids in the treatment of ankle sprains has been discussed, these drugs have never been included in treatment recommendations (2).Objective: To describe the rate of opioid prescriptions within 7 days after an ankle sprain and the ...References1. van den Bekerom MP, Kerkhoffs GM, McCollum GA, et al. Management of acute lateral ankle ligament injury in the athlete. Knee Surg Sports Traumatol Arthrosc. 2013;21:1390-5. [PMID: 23108678] doi:10.1007/s00167-012-2252-7 CrossrefMedlineGoogle Scholar2. Vuurberg G, Hoorntje A, Wink LM, et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med. 2018;52:956. [PMID: 29514819] doi:10.1136/bjsports-2017-098106 CrossrefMedlineGoogle Scholar3. Optum. Clinformatics Data Mart. Accessed at https://www.optum.com/content/dam/optum/resources/productSheets/Clinformatics-Data-Mart.pdf on 20 April 2019. Google Scholar4. Brummett CM, Waljee JF, Goesling J, et al. New persistent opioid use after minor and major surgical procedures in US adults. JAMA Surg. 2017;152:e170504. [PMID: 28403427] doi:10.1001/jamasurg.2017.0504 CrossrefMedlineGoogle Scholar5. Delgado MK, Huang Y, Meisel Z, et al. National variation in opioid prescribing and risk of prolonged use for opioid-naive patients treated in the emergency department for ankle sprains. Ann Emerg Med. 2018;72:389-400. [PMID: 30054152] doi:10.1016/j.annemergmed.2018.06.003 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Michigan, Ann Arbor, Michigan (F.T.F., T.D.G., H.M.H., J.F.W., C.M.B., D.M.W., P.G.T., J.R.H.)Financial Support: Funding for this study was provided by the University of Michigan Precision Health Initiative.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-0679.Reproducible Research Statement: Study protocol and data set: Not available. Statistical code: Available from Dr. Holmes (e-mail, [email protected]umich.edu).This article was published at Annals.org on 9 July 2019. 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Kansagara, MD, MCR, for the Clinical Guidelines Committee of the American College of Physicians and the Commission on Health of the Public and Science of the American Academy of Family Physicians*The Shrinking Grey Zone of Postoperative Narcotics in the Midst of the Opioid Crisis: The No-opioid UrologistVisit Characteristics Associated With Opioids Administered or Prescribed During Emergency Department Visits for Ankle Sprain Between 2010 and 2015The Management of Acute Pain for Musculoskeletal ConditionsCommentary on Burke et al . (2020): Safer and less‐frequent opioid prescribing are both essential for US public health 17 September 2019Volume 171, Issue 6Page: 441-443KeywordsAnklesDatabasesDisclosureDrugsInpatientsInternational Classification of DiseasesOpioidsOutpatientsOxycodoneTreatment guidelines ePublished: 9 July 2019 Issue Published: 17 September 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...