The CORE Project

CORE Expansion

This initiative has developed out of a study that was conducted by Dr. Nady Hamid for patients needing a total shoulder arthroplasty.  Patients in that study gave consent to be placed into a group receiving a non-opioid, multi-modal pathway. Results from that smaller study showed that treating patients without opioids was a safe and effective way to manage post-operative pain following total shoulder arthroplasty.

In 2017, OCRI launched a larger randomized, controlled trial to further validate their findings. The study found the opioid-free protocol to be safe, and effective in managing pain post-surgery.

Now, this elective opioid-free pathway is being built into the standard of care at OrthoCarolina for patients who prefer treatment without opioids. OCRI is also working to study the adoption and implementation of this pathway and preparing to scale it across healthcare systems across the Carolinas.

This study is being funded through a multi-year research grant awarded by the Duke Endowment.

Next Steps for CORE

• Expand Access: Scale use of opioid free surgery from study participation to everyday practice
• Empower Patients: Educate patients about their pain management options by providing resources. By disseminating our findings our goal is to equip patients to have conversations with their doctors about their care preferences
• Change Practices: Reduce opioid prescriptions by educating physicians worldwide of our novel opioid free surgical option. We will do this by growing OCRI’s outreach team with public health professionals

Current Practice for Most Surgical Care

• Opioids are a staple of pain management, given at the time of block for discomfort
• During surgery, opioids are given in response to fluctuations in heart rate
• In post-operative recovery room, they are given in anticipation of pain
• On the surgical floor, they are given whenever patient rates pain at or above 6/10
• Opioids are routinely given at time of discharge
• Complications due to opioid consumption are considered routine surgical recovery

About Opioid Abuse

• Opioid abuse statistics are staggering. More people die in the state of North Carolina of an accidental drug overdose, typically opioid-related, than any other cause of accidental death.
• In the United States, more patients are dying from substance abuse every year than from car accidents.
• Little has been done to date within the medical community to specifically answer how to prevent future opioid abuse at the initial encounter.
• North Carolina Attorney General Josh Stein has been vocal in his fight to combat the growing opioid epidemic in the state and is a supporter of the CORE Research Study. Learn more about the opioid crisis in North Carolina HERE.

“Opioid painkillers are highly addictive; the CDC reports that one of five patients who take 10 days of opioids will still be taking them 12 months later. And they are often not the most effective way to treat pain, as OrthoCarolina’s preliminary findings suggest. I’m encouraged by OrthoCarolina’s work to find non-addictive ways to treat pain, and I look forward to hearing about the results of its larger study.”

– NC ATTORNEY GENERAL JOSH STEIN