Surgical pain relief for those in recovery presents major challenges. Surgery means that preoperative medication, anesthetic and postoperative painkillers are needed. When pain relief involves narcotic painkillers, someone in recovery for addiction can relapse back into substance abuse if pain relief is not managed properly.
Medically necessary drugs for pain can pose a possible threat to sobriety, but using painkillers doesn’t necessarily lead an individual in recovery to relapse when less addictive narcotics are used and the patient is vigilantly monitored postoperatively.
Surgical Pain Relief for Those in Recovery Using “Weak” Opioids
Using opioids for surgical pain relief for those in recovery can trigger the brain’s limbic system to activate addictive behavior. One method of effectively managing pain relief with less relapse risk is using painkillers that are less addictive than other opioids. Tramadol is widely accepted as being safer for surgical pain relief for those in recovery, because of its weaker effects on the parts of the brain that can trigger relapse.1
When a drug strongly affects the brain’s reward system, it can lead to addiction or relapse. Tramadol is a substance that’s made to combat depression, but it also has very little effect on the opioid receptors in the brain. This means tramadol relieves pain, but it doesn’t strongly affect the brain’s reward system.
Surgeons should be informed beforehand that the patient has a history of addiction. As with any important surgical or treatment decision, confer with the surgeon to evaluate the risks and benefits of using narcotic drugs for pain relief for a person in recovery.
Surgical Pain Relief for Those in Recovery Using Vigilant Pain Management
An important part of keeping a recovering person from falling back into substance abuse is ensuring that both the doctor and patient closely and faithfully monitor the course of pain management.2 In the case of minor surgery, such as a tooth extraction, the patient should start feeling better after several days or up to one week. The surgeon should follow up with the patient in that timeframe to make sure the pain has dissipated. If the patient still reports feeling pain, the doctor can examine the patient to determine what’s causing the pain to continue.
When a person with a history of addiction is being treated with opioid pain medications due to more serious surgical procedures, a similar vigilant approach is needed. The postoperative patient should be monitored for pain relief, cravings, anxiety and any other symptoms that could lead to a relapse.
The patient should have supportive people around during the post-surgery phase. If the patient is in 12-step recovery, the sponsor should be involved. Once the patient is past the immediate post-op period, they should be monitored and opioid pain relief should only be given under supervision. Once the patient goes home, pain medications need to be monitored and controlled by an individual other than the patient or the patient’s family.
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