Now that the opioid epidemic has become front-page news, many people are questioning the safety of taking prescription painkillers, which can be highly addictive. However, in some cases, such as after surgery, pain relief is a very real need that must be addressed – and prescription opioids may be the best way to alleviate that pain.
First, let’s touch briefly on why prescription painkiller addiction is so dangerous. Then we’ll look at the latest scientific findings of how to manage pain after surgery while avoiding painkiller addiction.
How Avoiding Painkiller Addiction After Surgery Can Prevent Heroin Addiction
The opioid epidemic includes addiction to both legal prescription opioids and illegal opiates like heroin. In fact, the record-high rates of heroin addiction are actually driven by people first becoming addicted to prescription opioids.
All opiates and opioids relieve pain, but are highly addictive. Because the body builds up a tolerance to these drugs, higher and higher doses are needed to feel relief. Even when the source of an addicted person’s pain has healed, the body requires a continuous supply of the drug for daily functioning and to avoid withdrawal.
When prescription opioids become difficult to obtain, those who are addicted often turn to heroin as an alternative. This leads to even greater risks in the form of diseases transmitted through needles and the dangers of illegal drug activity.
You can learn more in our previous article “Understanding the National Heroin Epidemic and Its Tie to Prescription Drugs.”
Preventing Opioid Addiction After Surgery
Because of these dangers, those in need of surgery are rightfully asking questions such as:
- Is it safe to use prescription opioids or opiates due to surgery?
- For how long is it safe to take prescription painkillers after surgery?
- How can I (or a family member) avoid opioid addiction?
To answer these questions, let’s look at the findings from a study that was published in September 2017: Researchers at the Center for Surgery and Public Health at Brigham and Women’s Hospital analyzed data involving more than 200,000 patients over the course of eight years who underwent common surgical procedures and were prescribed opioid pain medication.
The researchers only included prescription data from patients who were opioid-naïve, meaning individuals who had no history of substance dependence, hadn’t had an opioid prescription in the last six months and did not have a prior diagnosis of chronic pain.
The team then used a mathematical model to analyze the prescription data, and from that, they determined optimal ranges of opiate prescription length depending on the type of surgical procedure performed:
- General surgery: 4 to 9 days
- Women’s health procedures (mastectomy, hysterectomy, etc.): 4 to 13 days
- Musculoskeletal procedures: 6 to 15 days
While this provides helpful guidelines, doctors are not always in agreement on how long is too long when it comes to opioid prescriptions. Some take a more conservative approach than others, and of course, each patient can respond differently to medication.
However, there are a few general practices that most medical professionals agree on.
Start Strong, Then Taper Off
The goal with opioid medication should be to alleviate pain quickly up front, then get off the medication as soon as possible.
One of the biggest problems that health professionals see is patients who take too low of a dose initially and then gradually increase the dose or use the same amount for an extended period. This can cause the body to start building up a tolerance and can lead to addiction.
Instead, doctors recommend taking a dose large enough to remove pain and discomfort right after surgery, and then tapering the dose down as the pain begins to subside. It’s important to get pain relief right away in order to heal quickly and avoid the development of chronic pain.
The length of time an opioid prescription is needed will vary depending on the procedure. Many people won’t need a prescription for longer than a week
However, some types of procedures may require medication up to 15 days after surgery for appropriate pain management.
Because of the serious risk of dependency with this type of medication, it’s very important to follow your doctor’s prescription faithfully.
Don’t take more – or less – than the amount prescribed, and take it at the recommended intervals and length of time.
If you aren’t getting the pain relief you need, talk to your doctor right away. Don’t tough it out, because this could lengthen the time you need pain medication, which puts you at greater risk.
Dispose of Unused Medication
If your pain clears up early and you have opioid medication left over that you no longer need, the safest thing you can do is to dispose of the unused medication right away.
This prevents misuse of prescription medication by yourself, family members or anyone else who may get ahold of it. By disposing of the medication properly, you help ensure that it can’t fall into the wrong hands and be sold illegally or contribute in any way to the spreading of the opioid epidemic.
Here’s a link to the FDA’s guidelines on how to properly dispose of unused medication.
Ask Your Doctor About Alternative Pain Management Options
If you’re concerned that your pain may last longer than two weeks, or if you are hesitant about taking opioid medications at all, ask your doctor about other ways to safely and effectively manage pain.
Opioid medications are only appropriate for severe, short-term pain. Chronic pain lasting more than two weeks should be managed using other methods that are safe for ongoing and long-term use.
What to Do If You Experience These Concerning Symptoms
Following the recommendations outlined above can greatly reduce the chances of painkiller addiction after surgery. However, check with your doctor right away if you experience any of the following symptoms when you stop or reduce the amount of opioid medication you are taking:
- Symptoms of withdrawal (chills, sweating, vomiting, cramps, etc.)
- Anxiety symptoms
- Increase in pain
Check with your doctor right away, but don’t panic either. There is a difference between dependence and addiction. Dependence is when the body becomes accustomed to the medication. Addiction is when the need for a substance takes over your life.
Medical professionals can help you overcome dependence long before it turns into an addiction, so long as you get help soon enough. Never hide a drug dependence from your doctor. It’s nothing to be ashamed of.
How to Help a Family Member Who’s Addicted to Painkillers
Now that the public mostly understands the danger of prescription opioids, many people are hesitant to take them at all. However, it’s important to understand that, when used correctly, prescription painkillers can be a safe way to manage pain and recover quickly from surgery.
But what do you do if you suspect that a loved one has not followed these guidelines and has already developed a dependence on prescription painkillers?
Seeking out professional medical advice is the first important step. Even though it may be uncomfortable to admit, realize that these doctors and nurses have seen it all, and they will appreciate that you’ve come forward and are willing to tackle the problem in a proactive way.
If your loved one refuses to acknowledge any sort of problem, then you may need to first get the help of a professional interventionist who can help the loved one see what is really going on and agree to seek medical help.