title: Perioperative substance use disorder, opioid diversion, and opioid misuse by a medical professional undergoing orthopedic surgery.
abstract: Patients with substance use disorders can present challenges for effective perioperative pain management. Healthcare professionals with substance abuse disorders requiring medical treatment and pain management represent a unique subpopulation. The authors present a case of a nurse undergoing an orthopedic surgical procedure who was found with two large, organized tackle boxes of opioid medication in her hospital room. Although the incidence of substance use disorders in healthcare professionals is thought to be equivalent to the general population, the presentation, substances of choice, and inciting factors are unique. Further, treatment options available to such individuals have been established and proven successful.
authors.affiliation: Resident, Department of Anesthesia and Pain Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Dermot P
authors.initials: DP
authors.lastname: Maher
authors.affiliation: Resident, Department of Anesthesia and Pain Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Michael
authors.initials: M
authors.lastname: Kissen
authors.affiliation: Chairman, Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Itai
authors.initials: I
authors.lastname: Danovitch
authors.affiliation: Program Director, Department of Anesthesia and Pain Medicine, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Roya
authors.initials: R
authors.lastname: Yumul
authors.affiliation: Director, Inpatient Pain Services, Department of Anesthesia, Cedars-Sinai Medical Center, Los Angeles, California.
authors.forename: Charles
authors.initials: C
authors.lastname: Louy
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001178:Arthroplasty / Q000009:adverse effects*; D016529:Emergency Nursing; D005260:Female; D006801:Humans; D008875:Middle Aged; D009741:Nursing Staff, Hospital; D009293:Opioid-Related Disorders / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation; D015207:Osteoarthritis, Hip / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D064226:Prescription Drug Diversion; D063487:Prescription Drug Misuse; D028743:Professional Misconduct; D015813:Substance Abuse Detection
chemical_list: D000701:Analgesics, Opioid