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Anyone can be one surgery away from developing an addiction to prescription pain medication. It’s estimated that 60% of the opioids that are abused are obtained directly or indirectly through a physician's prescription. But when a recovering addict needs surgery, the stakes are even higher. Cellular changes in opioid receptors can occur faster. Addiction can be reactivated or a new one can be formed. So is there a way to manage pain without risking drug relapse for addiction?
Who Is At Risk?
Certain people are particularly vulnerable to addiction. You can assess if you are in a higher risk group if you check off one or more of the following:
- Prior history of drug or alcohol addiction
- Past problematic use of pain medicine
- Parent or other family member with addiction
- Unresolved childhood trauma
- Co-occurring mental health disorders such as depression and anxiety
Long-term use of opioids for chronic pain is known to cause opioid use disorders. And there are risks around exposure to opiates after surgery for everyone. How much pain medicine does it take to form a painkiller addiction? The Centers for Disease Control and Prevention (CDC) has found that prescriptions for three days or less can help reduce opioid addiction or misuse. Research shows that for people predisposed to addiction, cellular changes in response to opioids can occur with as little as five days of exposure.
6 Ways to Avoid Addiction Post-Surgery
Doctors and hospitals have tended to give postoperative patients more opioids than needed and do not educate them about the potential dangers of opioid medication. Research shows that people who get addicted to pain medicine often move on to less expensive, more readily available heroin.
Painkillers can’t always be avoided entirely. But studies show that if people in recovery have the proper education and a limited amount of the medicine and are open to alternative forms of pain relief, they can heal without risking their sobriety. Here are a few tips for creating a recovery-friendly pain management plan.
- Talk with your surgeon. Some hospitals are already making an effort to reduce the amount of opioids prescribed to postoperative patients in multiple surgical specialties. A recent study showed a drop in opioid prescriptions when surgeons offered education and options for pain relief. Encouraged by their doctors to use a nonsteroidal anti-inflammatory drug (NSAID) and acetaminophen before using opioids, 85% of patients went without opioids. Share your concerns with your surgeon.
- Discuss pain medicine in advance. Tell your entire medical team, from surgeons and residents to attending physicians and nurses, that you are in recovery and ask for this to be taken into consideration while in the hospital and in prescribing medicine. Request the smallest amount for the shortest amount of time. Balance the need to control pain with non-narcotic pain relief.
- Ask about regional analgesia. Pain after surgery is unavoidable and can be debilitating, but for some surgical procedures the need for pain medication can be delayed if the physician uses an analgesic technique during the surgery. It is not something a doctor would automatically do so discuss the options.
- Enlist your support system. Reach out and ask for support. If you are in a 12-step program or outpatient treatment, tell the people around you about your medical situation. Have friends visit you in the hospital and ask them to come to your home to help distract you from pain and to support you in maintaining your sobriety. If you are unable to attend meetings for a while due to surgery, ask friends to have them in your home.
- Give the medication to a responsible party. Don’t tempt the hands of fate by thinking, “I can handle this on my own.” If you have to use opioid medication for a short amount of time, put the bottle of pills in the hands of someone who can keep them out of sight, give them to you as needed and will not let you take more than prescribed. They frequently do that in drug trials that involve either narcotics or treatment for narcotics, so that the drugs aren’t abused.
- Plan for alternative pain relief. It takes time to heal from surgery and pain relief allows the body to heal faster, but people who have already experienced addiction should look into complementary pain management approaches, including:
Mindfulness meditation – Using brief meditations, patients can shift their moods and their response to pain. Mindfulness meditation is used to help self-regulate chronic pain as well as attenuate other forms of pain.
Hypnosis – This popular nonpharmacological means for managing surgical side effects has been used for pediatrics, post-surgical adults and cancer patients. Research has shown hypnotic analgesia may enhance nervous system inhibitory processes that attenuate pain.
Auricular acupuncture – Stimulation of acupuncture points in the external ear has been shown to help reduce pain after hip surgery and ambulatory knee surgery.
Relaxing music – Research has shown that sedative music has been effective in reducing pain and anxiety in open-heart surgery patients.
Foot and hand massage – Massage can take the focus off of pain and promotes relaxation.
Although there is greater awareness of the opioid crisis and how addiction can begin with pain medicine prescribed after surgery, there is still more education needed on best prescribing practices and also catching drug addiction before it begins. The CDC has suggested physicians prescribe less and refuse unnecessary prescriptions. But people in recovery from addiction have to take the extra step of informing their physicians of their special vulnerabilities and asking for help so they can have the healthiest, least painful surgical recovery.
