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Official websites use. Share sensitive information only on official, secure websites. The work cannot be changed in any way or used commercially without permission from the journal. We aim to examine temporal trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than any others. As aging society advances in the United States U. A serial cross-sectional cohort study using the healthcare cost and utilization project fast stats from through measured annual rate per , populations of orthopedic operations by age groups 45—64 vs 65 and older as well as annual rate per , populations of opioid-related hospital stays among 65 and older in the nation, Oregon and Washington states from through Orthopedic operations knee arthroplasty, total or partial hip replacement, spinal fusion or laminectomy and opioid-related hospital stays were measured. The CAGR 4. The CAGRs of opioid-related hospital stays among age 65 and older were upward trends among seniors in general 6. Orthopedic operations and opioid-related hospital stays among seniors increased over time in the U. Marijuana legalization might have played a role of gateway drug to opioid among seniors. The growing crisis of the United States U. The prevalence of aging-related orthopedic conditions necessarily increases along with the prolonged life expectancy. In the U. However, the strict controlled substance policies make the opioid prescription more difficult across the states. Also, in order to reduce misuse and abuse of prescribed opioids, more than 30 states have implemented the prescription drug monitoring program PDMP during the past 2 decades. Yet, PDMPs have not been effective in reducing drug overdose mortality rates. Federal rescheduling hydrocodone product, the most commonly prescribed opioid analgesic, from schedule III to schedule II in faced unexpected increase in opioid-related hospitalizations without documented opioid prescriptions that may represent an increase in illegal use among Medicare beneficiaries. No previous studies focused on the trends of orthopedics operations due to degenerative joint diseases in general among older adults. Older adults are particularly susceptible to toxicity and adverse effects from opioid use. Although medical marijuana laws are associated with a reduction in overdose deaths from opioid pain relievers, the effect of marijuana legalization on both prescribed and illicit opioids use needs further attention, in older adults in particular. The current brief report examined temporal trends of orthopedics operations due to degenerative joint disease and opioid-related hospital stays in the nation and states of Oregon and Washington where marijuana legalization was accepted earlier than other states and shared similar timeline of legal processes. Study design was a serial retrospective cross-sectional data analysis. We obtained data from the healthcare cost and utilization project HCUP fast stats: most common operations during inpatient stays from through and opioid-related hospital use in the nation, and states of Oregon and Washington from through HCUP, and Institutional review board review was not necessary because all data were secondary, completely de-identified, and publicly available. The main measurements were annual rates per , populations to estimate the trends of orthopedic operations and opioid-related hospital stays. Orthopedic operations were limited to the hospital inpatient procedures for degenerative joint conditions: knee arthroplasty, total or hip replacement, spinal fusion or laminectomy. Orthopedic operations and opioid-related conditions were identified by using the international classification of disease, 9th revision until 3rd quarter or 10th revision from 4th quarter , clinical modification ICD-9 or CM and were defined by the HCUP elsewhere. Young age groups were not added in analysis due to too low rates of orthopedic operations. The compound annual growth rate CAGR was used to quantify temporal trends of annual rate of orthopedic operations and opioid-related hospital stays per , populations. Figure 1 B presents trends of annual rate of opioid-related hospital stay per , The CAGR of opioid-related hospital stay was 6. We also found out the geographic variation in the trends of opioid-related hospital use among 65 years or older. These gaps were less than 2 times in However, these gaps were more than twice in A Annual rate of orthopedic operations by age groups: Upward trends of orthopedic operations and opioid-related hospital stays among older adults were observed in the nation in general as well as states of Oregon and Washington states where marijuana legalization was accepted earlier than other states and shared similar timeline of legal processes. In response to the increased volume of orthopedic operations, a substantial growth in opioid prescriptions among 65 years old and older Medicare beneficiaries have been observed in the previous nationally representing data. Oregon and Washington states share the similarity of drug policies such as the same year of PDMP in and medical marijuana legalization in , and its dispensary in It has taken over 11 years from the legalization to the local dispensaries, older adults eagerly waited for the medical marijuana to become available. Middle-age group 45—54 years most likely will have similar degenerative joint diseases in near future and may follow the similar trends to the current older adults. In fact, the recent study using a nationwide private insurance claim database, there was no association between the number of initial opioid prescription and likelihood of opioid refill after surgery. Upward trends of the opioid-related hospital use among seniors in general and in Oregon and Washington in particular, call for immediate actions. First, research should precisely differentiate purposes of opioid-associated hospital use in a nationally representative sample. Second, more interdisciplinary and patient-centered care should be taken to manage older adults with degenerative joint diseases. For example, possible interventions include:. We acknowledge several limitations. First, usually, low sensitivity and high specificity in weighted estimates occurred when identifying persons who use illicit drug from administrative claim data. Despite these potential limitations, we believe this is the first study to report several new insights to the current. To the best of our knowledge, there was no previous study that examined the trends of orthopedic operations and opioid-related hospital stays among seniors in the nation and states of Oregon and Washington where marijuana was legalized. As a library, NLM provides access to scientific literature. Medicine Baltimore. Dissociation between the growing opioid demands and drug policy directions among the U. Find articles by Pearl Kim. Find articles by Takashi Yamashita. Find articles by Jay J Shen. Find articles by Seong-Min Park. Find articles by Sung-Youn Chun. Find articles by Sun Jung Kim. Find articles by Jinwook Hwang. Find articles by Se Won Lee. Find articles by Georgia Dounis. Find articles by Hee-Taik Kang. Find articles by Yong-Jae Lee. Find articles by Dong-Hun Han. Find articles by Ji Eun Kim. Find articles by Hyeyoung Yeom. Find articles by David Byun. Find articles by Tsigab Bahta. Find articles by Ji Won Yoo. Published by Wolters Kluwer Health, Inc. Open in a new tab. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

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