 The severity and complexity of the injuries and pain experienced by trauma patients makes the use of regional and local anesthesia for pain management insufficient. A multimodal pain regimen (MMPR) aims to reduce opioid exposure in trauma patients without compromising their pain score. A study conducted at the Red Duke Trauma Institute in Texas evaluated the MMPR and found that though successful at reducing opioid exposure without compromising pain scores, it is not universally sustainable. The medications involved are costly for hospitals and not covered by insurers after patient discharge. In comparison, the Multimodal Analgesic Strategies in Trauma (MAST) MMPR uses generic drugs that are mostly available over the counter, with gabapentin and as-needed opioid being the only drugs requiring prescription. Fewer patients in the MAST MMPR group were discharged requiring opioids in comparison to the MMPR group. The MAST MMPR regimen can be adopted in any trauma center, however this will require extensive education and initiative on the staff’s part.
 Fatal opioid overdoses and opioid use disorders cost the United States $1.02 trillion in 2017. The most complete accounting to date of America’s opioid crisis was released by CDC in the journal Drug and Alcohol Dependence. This is a substantial increase from the 2015 estimate of $500 billion. The costs include: health care ($31.3 billion), opioid use disorder treatment ($3.5 billion), criminal justice ($14.8 billion), and lost work productivity ($100 billion).The majority of the economic burden can be attributed to loss of life due to fatal opioid overdose ($480.7 billion) and reduced quality of life from opioid use disorder ($390 billion). The cost estimation helps us understand the impact of the opioid epidemic and helps inform public policy, clinical practice, research, and prevention and response activities.
 A cross-sectional analysis of 11.8 million hospitalizations from 47 states and the District of Columbia revealed that from 2010 to 2017 the rates of neonatal abstinence syndrome (NAS) and maternal opioid-related diagnosis (MOD) increased significantly. This holds true for nearly all states and demographic groups. The majority of patients with NAS and MOD were non-Hispanic white, in urban areas, and Medicaid beneficiaries. However, rural residents saw larger increases and 2017 rates were almost double of that of their urban residents. MOD and NAS are associated with poor health outcomes for both the mother and the infant. These increases highlight the need for state-level policies and programs addressing the need for substance-use program targeted toward expectant and new mothers.
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