What begins as a short-term solution for post-operative pain often turns into a serious addiction to opiate painkillers. A new study has found that patients who are given prescriptions for opioid drugs like codeine and oxycodone for pain following minor surgery are 44 times more likely to be classified later as long-term opioid users.
The study, which was published in the Archives of Internal Medicine, involved almost 400,000 people age 66 and older who had minor surgery that required a short hospital stay. Typical surgeries included cataracts, varicose vein stripping, prostrate tissue removal and laparoscopic gall bladder removal. Pain medication for this type of surgery is usually only needed for 10 to 14 days. Within one year after surgery, 10 percent of the patients studied were found to have become long-term opioid users.
Following surgery, patients are frequently given a painkiller prescription not because they complain about pain, but in anticipation of future pain after they leave the hospital or surgery center. The casual distribution of addictive medications like codeine and oxycodone (which is marketed under the name OxyContin) in post-surgical situations is apparently an invitation for abuse. In addition to posing a risk to the patient, unused prescriptions often end up in medicine cabinets where they can be accessed by other family members and guests, creating additional risks of abuse.
Although opioid drugs are associated with pain relief, they have unpleasant side effects that include constipation, sedation, breathing problems and addiction. According to authors of the study, doctors should first try non-opioid pain medications when writing prescriptions for patients after minor surgery. Dr. Chaim Bell, one of the study’s authors, points out that it’s much easier to avoid giving a patient an opioid prescription than to try and wean them off the drug after they have become dependent.
According to Dr. David Maine, director of The Center for Interventional Pain Medicine at Baltimore’s Mercy Medical Center, the decision to start treatment with an opioid drug is a serious one that must be carefully considered by healthcare providers. The type of painkiller prescribed and the specific dosage should be tailored to each patient’s specific needs and background.
When opioids are prescribed, the physician should recheck the patient after a short interval to determine the effect of the drug and the patient’s tolerance. If there is an issue with either, then a change should be made. If necessary, the change may be discontinuation of the opioid drug.
In addition to addiction, opioid painkillers carry a risk of death by overdose. The Centers for Disease Control and Prevention reports the number of nationwide overdose deaths from opioids increased from 4,000 in 1999 to 13,800 in 2006. That number continues to rise as the problem of opioid abuse and addiction spreads into every sector of the population.