May 31st, 2019

The OrthoCarolina Research Institute hit a milestone in our largest single-institution study this week.

Since starting Carolinas Opioid Reduction Effort (CORE) Project surgeries last year, OrthoCarolina physicians have performed 100 randomized surgeries for the study.

That means 100 people have elected to join our clinical trial. Randomized surgeries mean patients have given their permission to be randomly placed into two research groups- surgery with opioids (how it’s traditionally done) and surgery without opioids (a new protocol created by OrthoCarolina).

The goal of the CORE Project is to find alternatives to opioids and disseminate findings to patients, providers, and healthcare systems in the Carolinas and beyond. The project focuses on reducing avoidable opioid prescribing and consumption in elective orthopedic surgery.

Little has been done to date within the medical community to specifically answer how to prevent future opioid abuse at the initial encounter. Here at OrthoCarolina, we believe it’s our responsibility to do our part in finding alternatives to opioids for our patients.

With this milestone, we’re thrilled that we’re on our way to be able to share our findings with the world!


Years ago, OrthoCarolina Sports Medicine Physician Dr. Nady Hamid had a patient who had shoulder arthroplasty.  The patient came back a few years later to have the other shoulder done and asked Dr. Hamid to perform the surgery without opioids. It would seem like a bizarre request if you didn’t know this patient’s story. You see, after the first surgery he found himself addicted to opioids. He then lost his job, his marriage, his home and ended up in rehab. While piecing his life back together, he was in pain, but couldn’t risk what would happen if he had opioids prescribed to him again.

Dr. Hamid researched the medication combinations and worked with other specialists to determine a combination of already available medications that could be used at different intervals to avoid opioids before, after and during surgery.  The success with this patient led to a research study.

We looked at 65 patients who received shoulder arthroplasty and the results showed equal or better pain control and none of the harsh side effects. From that initial study, we embarked on a larger study that involves multiple subspecialty clinics within OrthoCarolina. We are exploring a non-opioid pain pathway across a number of surgeries in sports, foot and ankle, hip replacements, hand and even spine surgeries.  We received a grant from the Duke Endowment in 2017 to continue to study these alternatives, but to also do community outreach and education along the way.

You can learn more about the CORE Project at