Need advice on post surgery pain for a former addict

[kauaimuse]

My son is having back surgery next week. He is a former addict to pain killers for the same back problems. He went through treatment for his addiction last year. He has not told his new surgeon about his previous addiction and I'm very concerned that he will become readdicted post surgery or that his needs for anesthesia may even be different because of his history. I'm flying in to be with him and am very anxious to know what I should do.
Thank you

[reconche]

yes he should definitly tell his doctor. that way they can work with him.

[LittleLai]

I'm a little unclear. I'm on Suboxone which nullifies opiate effectiveness.

I just broke my foot (welll they thought I did) a week ago and gave me Norco's. They of course did nothing (neither high nor pain relief.) (BTW- I've been great about staying clean, I just tried it as an experiment for this very question.)

First of, I decided to keep a copy of my script in my wallet

So lets say I go into emergency surgery, will the Morphine etc not work?

Is there any alternative?

What about five years from now when I'm off Suboxone?

[GA Guy]

Part of the Hippocratic oath is the pledge to "do no harm". Leaving pain untreated is doing harm, and any surgeon that does so should be reported...addict, recovering addict, or not.

[slideshow]

I can't spell, of course I meant guy not buy.  It's not necessary to use the word addict when talking with the doc.  He should of course tell him about previous, but more about current meds.  If he has not taken in a year, those year old meds are not going to be affecting his body now.  The surgeon does not have to know that the guy is an addict, but a simple honest conversation about concern for he narcotics and asking previous to the plan, for a plan to taper down the pain meds.  It's a responsible request.  If you overdo the addict thing with the surgery, this guy will be in real pain as the surgeon will be negatively influenced by the word "addict"

[slideshow]

Telling the surgeon that he is an addict WILL result in his pain being undertreated.  This is a decision that the buy should be in on.

[lurker]

Speaking as a nurse here, I'm encouraging you to tell the doctor.  Former addicts can have unusually high tolerance to narcotics and also to some of the medications used for anesthesia.  It is really important for the caregivers to be aware of his history.  They will not withhold medications from him but will be very cautious and may even try nonnarcotic alternatives for pain management.  There are several high tech options available for post op patients, like infusion the drugs directly into the surgical site.  You can also keep his take home meds with you and dispense them as directed to help him avoid the temptation of taking them for purposes other than pain.  He's very lucky to have you.  Good Luck!

[beachtowel]

He should probably be honest with his doctor and tell him that he is an addict but he probably won't worried that he will be left to suffer in pain.......
There is legitamate pain but the problem would be dispensing his meds.......
Does he have someone who can support and help him with that area?
A loved one or family member that can stay with him to dispense his meds so he won't swallow the whole bottle and beg for constant refills?

He should not have to suffer in pain because he is an addict after his surgery.....
But his brain will not forget the Euphoric feelings from the narcotics......
I hope his surgery goes well and obviously he has you in his corner someone that has true care and concern for his welfare......he is lucky........

[GA Guy]

If it's been a year since he's used, then he's probably very close to normal as far as his body goes. use of opiates, even short term, can bring back the devil so to speak. I'd advise him to not try and be a hero, but discuss this issue with his doctor and have an exit plan for post surgery. Weaning him slowly off the meds after surgery can help. It's something he should discuss with his surgeon. Any doctor worth his salt will respect your son's addiction and help with a plan to make sure he doesn't relapse after surgery.