Opioids Often Not the Answer to Post-Surgery Pain, Discomfort, Note Physician Anesthesiologists

CHICAGO – It’s a given that surgery is painful and may leave you 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 post-surgery recovery room with a prescription for 30 or more highly addictive opioid pills (such as 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 and may benefit 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 and 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.

So don’t take that chance. During Physician Anesthesiologists Week (Jan. 28 – Feb. 3), ASA offers advice for coping with pain and discomfort as you recover from surgery.

• Ask about alternatives – Opioids should be taken only when in extreme pain. Medications such as ibuprofen (Motrin), naproxen (Aleve) and acetaminophen (Tylenol) can effectively manage 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 it’s important to realize that 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. Think about when you have your teeth cleaned at the dentist or exercise particularly vigorously. You might be sore afterwards but you know it will pass, and wouldn’t think of taking an opioid to manage the discomfort. You would likely turn to ibuprofen or naproxen to ease the soreness.
• 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, noting if you are sore, uncomfortable or in serious pain. If you are in major pain, ask that the opioid prescription be written for a small amount, such as five pills, as 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. Keep in mind, your pain will improve significantly within a few days whether or not you take opioids.
• Limit the opioids – If you are in severe pain and are prescribed opioids, use them sparingly. Take them only for a day or two after surgery, three days at most.
• 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, meaning they can actually increase sensitivity to pain.

“The opioid crisis is huge and affects everyone, rich and poor, male and female, folks who live in urban areas as well as rural areas. 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 other 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.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 52,000 members organized to raise and maintain the standards of the medical practice of anesthesiology. ASA is committed to ensuring physician anesthesiologists evaluate and supervise the medical care of patients before, during and after surgery to provide the highest quality and safest care every patient deserves.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about the role physician anesthesiologists play in ensuring patient safety, visit asahq.org/WhenSecondsCount. Like ASA on Facebook and follow ASALifeline on Twitter.

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