Non-narcotic pain management after surgery

[makanui]

In the end of December I found out that my Boyfriend had been getting Percocet off the street and from people at his work and had relapsed with his opiate addiction which had been kept at bay for the past 4 years. Starting December 29th, 2009, he stopped using. Two days later on December 31st, 2009 he fell snowboarding and separated his AC joint in his right shoulder.  I was terrified that this injury would soon lead to a prescription of opiates.  I have informed every doctor we have seen thus far, including even the ski patrol and the ER on the night of his accident.

Just yesterday, on what would have been his 23rd day of sobriety, he came home and I could tell he was on something.  His pupils were the size of a pin-head, his heart was racing, and he was scratching his back incessantly. I asked him what he was on and he told me that someone at his work gave him a Vicodin and that it is not as bad as a Percocet. He then told me that he would probably be getting a Rx for in soon anyway because of his upcoming surgery to fix his shoulder on January 27th.  I then told him the pain management appointment that we are going to tomorrow is for that exactly. Now he said he does not even want to go to that appointment because all they will prescribe is Ibuprofen, Aspirin or Naproxen Sodium......

1 year ago a really great friend of mine passed away because he relapsed on his opiate addiction after a year of sobriety. His relapse began when he was prescribed opiates by his surgeon after a minor procedure that left him with only 2 stitches. Apparently his addiction to opiates was not in his medical record and even though his Mother informed the surgeon, he handed my friend the prescription right in front of her. I am scared to death that this will happen to my Boyfriend. . .

Can anyone give me their input and experience with non-narcotic pain management and possibly how it relates to opiate addiction?

[Tuckamore]

Hello and Welcome to the Pain Mangement Forum. I see that you have also posted on the Substance Abuse Forum. I think you have made two good choices.

I understand your concern with your bf, especially with your friends passing. I am so sorry that you lost your friend. But understand that you cannot make your b/f stay clean if that is not his wish. He has to want to maintain his sobriety. You will drive yourself crazy trying to do what he must do which is take responsibility and recognize his addiction and take positive steps towards recovery. This has to be his choice.

He will have significant pain post-op. To suggest that he can tolerate surgery and immediate recovery without narcotics is not practical. Untreated severe and acute pain will interfere with the healing process and prolong his recovery. It is doubtful a surgeon would not prescribe a narcotic for him unless the b/f refuses it.

Down the line there are some good NSAID's and similar non-narcotic pain relievers that should be effective in pain control. His surgeon and or PCP should be able to help him with this.

My heart goes out to you. Addiction is a disease. If you plan to stay with your b/f you may want to consider joining one of the national support groups affiliated with AA. Best of luck to you both.

Take Care,
Tuck

[sandee1818]

Hi,
     I am so sorry to hear of your boyfriends addiction problems. He does have some wonderful support in you and that is important. It will be difficult for him as he deals with the pain he suffering and the pain he will endure after surgery. There are plenty of non narcotic medications but to be really honest it is going to be very hard for him to try and stick with them. My Mom in law had shoulder surgery and it was painful for her. She refused to take narcotics and used the non narcotic pain relievers and they did not do much for her pain.It is best that the doctors know he has an addiction problem up front so they can try and help him with his pain in other ways.
I am sorry for your loss and know this is weighing greatly on your mind. Dealing with pain is tough enough without having to deal with addiction issues along with it.
Do not misunderstand me there are some wonderful non narcotic medications he can use. If these do not work well enough for him perhaps for the few days after the surgery you can administer his medications. I know this would be asking alot of you but you seem to want to help him through this the best way possible without him suffering to much.
I would talk to the surgeon and PM doctor and ask them if they can control his pain adequately with non narcotic pain relievers and if not perhaps discuss with them your administering his medications until atleast the week after his surgery. By the end of the week after surgery he should be able to manage his pain efficiently with the non narcotic pain relievers.
I applaud your effort to help him he is lucky to have someone so strong and willing to help him through this with as little pain as possible. Just keep in mind that dealing with pain day in day out can be very stressful and may make him short tempered and feeling angry.
There are some wonderful non narcotic medications as I said and they may work well for him. I wish you both the best of luck. We are here for you both and will answer any questions you may have and are here if you just want to talk also:)
Keep us updated on how things are going.