“…Guidelines for OA management recommend holistic assessment with a multidisciplinary approach that includes non-pharmacological, pharmacological, and surgical interventions (14)(15)(16)(17)(18). Importantly, there have been growing concerns for a number of years on the potential toxicity (especially in the US) and lack of benefits for opioids, which have been a staple in OA treatment recommendations (15,(19)(20)(21)(22).…”