Consider alternatives to opioids to manage pain after surgery
If you’re having surgery, you can expect to be sore and uncomfortable for a few days, whether you’re recovering at home or in the hospital. But it’s best to limit opioids or avoid them altogether, opting for alternatives to manage pain and discomfort, recommends the American Society of Anesthesiologists (ASA).
Unfortunately, many patients leave the hospital following surgery with a prescription for 30 or more highly addictive opioid pills (e.g., Vicodin, hydrocodone and oxycodone), and about 6 percent are still using them three months or longer after the procedure.
“Nobody needs a prescription for 30 or 50 opioids, and even those who are in major pain should only take them for a day or two,” said ASA President James D. Grant, M.D., M.B.A., FASA. “There are effective alternatives. Many people don’t need opioids at all or at least should drastically reduce the amount they take.”
Addiction can start after taking only a few opioids. More than 2 million Americans abuse these medications, which can create a feeling of euphoria and make the body believe the drug is necessary for survival. Since 2000, opioid overdose deaths in the U.S. have increased 200 percent.
Don’t take that chance. ASA offers advice for coping with pain and discomfort as you recover from surgery.
* Ask about alternatives – Only take opioids when you are in extreme pain. Medications such as ibuprofen (Motrin), naproxen (Aleve) and acetaminophen (Tylenol) can help with pain and soreness. While it’s never a good idea to rely on any type of pain pills for too long, these medications are not addictive and are far less risky than opioids.
* Manage your expectations – Everyone feels pain differently, but soreness and discomfort after surgery are normal and will improve within a day or two. These sensations are less severe than pain, which is usually sharp or intense. You usually don’t treat muscle soreness after a hard workout with an opioid, so if you are sore, and not in severe pain, try ibuprofen or naproxen.
* Be an active participant in your own care – While you are in recovery, the nurse will ask you if you are in pain and if so, how much. Be descriptive in explaining how you feel. If you are in major pain, ask that the opioid prescription be written for a small amount, and only take them for a day or two, three at most. Unused pills can fall into the wrong hands. In fact, more than half of people who misuse prescription painkillers get them from a friend or relative. Your pain will improve significantly within a few days whether or not you take opioids.
* Be aware of other downsides to opioids – Opioids cause severe constipation and often don’t manage pain as well as people expect. Additionally, they can cause hyperalgesia, or an increased sensitivity to pain.
“The opioid crisis is huge and affects everyone, rich and poor, male and female. It’s got to stop, and reducing opioid use during recovery after surgery is a big part of the solution,” said Dr. Grant. “Those who are in continued severe pain after surgery should ask a physician anesthesiologist or other pain specialist about alternative strategies to manage pain, including exercise, nerve blocks and non-opioid medications.”
ASA is committed to ending opioid abuse and has launched several initiatives to combat the epidemic. For more information, review ASA’s National Pain Strategy.
To learn more about the critical role physician anesthesiologists play before, during and after surgery, visit asahq.org/WhenSecondsCount.