Pain after surgery is expected and is managed using prescription and over the counter medications. Opioids (narcotics) are effective for treating pain in the short term after operations, but are dangerous and addictive with long-term use. Previous studies have shown that people who have surgery often get prescriptions for more pills than they need and ultimately keep these left-over pills in their medicine cabinets. This is not only dangerous for the patient, but also put their family and friends at risk. A recent study demonstrated that prior opioid dispensing to family members was associated with a significant increased risk of individual overdose. (JAMA Intern Med. 2019;179(9):1186-1192. doi:10.1001/jamainternmed.2019.1064). We developed this policy in an effort to protect our patients and their families from the risks of prescription narcotics.
Your initial pain prescription will contain a number of pills determined to be appropriate by your physician. We understand that pain may last longer than this initial prescription will cover, and we will refill prescriptions on a case-by-case basis. Prior to issuing a refill, we are required by Colorado Law (SB 18-022) to check the Prescription Drug Monitoring Program Database for opioid prescriptions from other healthcare providers. Patients still requiring opioid pain medication 1 month following surgery will be referred to a pain management specialist.
In order to limit the use of narcotic pain medication, we encourage patients to utilize these non-opioid pain management strategies:
- NSAIDs (Ibuprofen and Aleve) – over the counter anti-inflammatory medications which can be safely taken in addition to your prescribed pain medication. Take only one kind of NSAID.
- Acetaminophen (Tylenol) – can be used in addition to your pain medication only if your pain medication does not contain acetaminophen. Do not take more than 4000mg/day.
- Muscle relaxers (Robaxin aka methocarbamol, valium aka diazepam) – your surgeon may prescribe a muscle relaxer which can typically be taken with or instead of your opioid pain medication
- Ice – can help numb the area and decrease the swelling for the first couple days. You may then switch to heat. Heat can also help with pain associated with muscle spasm.
- Lidocaine patches – available over the counter and can be applied near incisions to help with pain
- Rest – your body needs time to heal after surgery, make sure you are getting plenty of rest. You will probably notice you are more tired than usual for 2-3 weeks and this is normal.
You may have leftover pills after your recovery. Do not flush your excess pills down the toilet. This may poison the water supply. We strongly encourage you to properly dispose of your pills by taking them to a pharmacy that provides a public disposal or to a “takeback.” Leftover pills are a hazard to your family members and friends. Studies have shown that over 50% of people who misuse opioids obtain them from family or friends that have leftover pills. Refer to this website for drug takeback programs in your area: https://www.colorado.gov/pacific/cdphe/colorado-medication-take-back-program