Surgery, Pain Killers & Recovery

So, you have planned surgery coming up, are in recovery, and feel conflicted about whether or not you should take pain medications post-operative.

On one hand, several of your friends in recovery are adamantly advising you too definitely “not” take the pain medications; on the other hand, from your own research (on pain and healing time) you have learned that when one is in pain, they heal more slowly.

Your friends are concerned that being on the pain medications you will end up with a “habit” and return to your former using ways; regardless of whether or not pills were your primary addiction in the first place.

You are concerned since your readings on pain and healing time indicate that without the pain medications you will be in pain longer and heal more slowly; the longer I remain in pain, the higher the possibility of my wanting to self-medicate the pain away.

What should I do?

Take the pain medications.

However, I suggest this with several stipulations in mind.

The first is to have someone else hold the medication for you; even if pain killers were not the issue when you were an active addict.

Secondly, make sure the prescribing doctor titrates the medication down over the course of the prescription to end at zero.

It should never be here are 90 Percocet’s, take three a day for thirty days, and then stop. Then just stop? What are you kidding me? Even people without an “addiction” would feel withdrawal after that.

Having been a preceptor in the past for first year residents at a local area medical school on addiction & co-occurring disorders, I was always amazed at how little overall training time our future doctors were getting on addiction & other mental health issues.

Then again, I must admit I am biased due to working in the field of addiction. I view my position with doctors as that of a colleague in this arena; we learn from each other. We can and do work together on addiction issues.

A suggestion that I make to all my patients and clients is to find a PCP (primary care physician) that belongs to A.S.A.M. - American Society of Addiction Medicine. Doctors that join this organization are attending workshops throughout the year to stay current in the field of addiction and addiction treatment.

Is this a guarantee that the doctor will always prescribe appropriately for those that have addictions? No, not necessarily. However, by belonging to A.S.A.M they are obtaining more information on addiction & addiction treatment then they initially received in medical school. This can increase the quality of care for their patients that have addiction issues (active or inactive).