The epidemic of opioid addiction continues to sweep the country, and North Carolina has been hit especially hard. The state has seen a 73 percent increase in opioid-related deaths since 2005.
If you’ve seen these statistics on the news or know someone who has struggled with addiction, you might have some concern about taking opioids. These powerful painkillers are prescribed to manage serious pain after surgery and other medical procedures.
Brooke Chidgey, MD, a pain management specialist at UNC Medical Center, understands these concerns and encourages patients to talk to a doctor about them. Ideally, that conversation would take place before the procedure.
It all comes down to planning.
“If you were going on a trip, a detailed map and itinerary would certainly ease your apprehensions,” Dr. Chidgey says.
That’s why she says to talk to your doctor beforehand, and consider asking these questions as part of your conversation.
Question No. 1: What kind of pain should I expect?
Start with asking your doctor what to expect in terms of pain.
“If you have realistic expectations, then your outcome will be better,” Dr. Chidgey says. “Some people are overly nervous, thinking the pain will just be horrific. Others think their recovery is going to be no big deal, and then when they do have pain afterwards, they just can’t handle it.”
Having the conversation also helps you get on the same page as your doctor.
“In many cases, the surgeon is pretty singularly focused on fixing the problem at hand, while the patient is mostly focused on the pain. You need to make sure you are addressing postoperative pain management in each conversation with your physician.”
Question No. 2: What’s the timeline?
Postoperative pain is unavoidable. No matter how seemingly minor the procedure, the reality is that doctors have made an incision, gone in and removed something, or fixed a problem. So it’s going to hurt. Part of planning for postoperative pain is understanding how the pain will progress over time and when you need to call your doctor for additional help.
“Your pain should be decreasing day after day,” Dr. Chidgey says. “If your pain seems unbearable and is not improving, you should contact your physician. And if your pain increases after a few days, definitely contact your physician, because at that point we are worried about the possibility of a complication such as an infection.”
Question No. 3: Are there nonopioid options?
Dr. Chidgey advises that patients ask about nonopioid options for pain control.
“A lot of people are surprised by how well ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) can work,” Dr. Chidgey says. “Your assumption is that you will need these very strong painkillers, but those types of drugs can be just as effective, without the added risk. Then, of course, there are other things, like ice, that can be really helpful in your recovery.”
Things to Remember About Opioids
When it comes to opioids, it’s important to use them sparingly and stop as soon as you can.
“Just because you were given opioids doesn’t mean you have to take them,” Dr. Chidgey says. “If your pain is mild or moderate, you would be fine with ibuprofen or acetaminophen. Opioids should only be used in instances of severe pain.”
If you use them sparingly, you’re likely to have pills left over. It’s critical to dispose of them properly; government figures show that 75 percent of opioid misuse starts with people taking drugs that were originally prescribed for someone else. This is often a family member, friend or roommate.
Don’t throw them in the trash, where they could be found and used. Don’t flush them down the toilet, since that can contaminate the water supply.
UNC Health Care offers locations where people can drop off unused medication.
MedSafe boxes are located at:
- UNC Hillsborough Outpatient Pharmacy – Lobby Level, Hillsborough Hospital
- UNC Medical Center Central Outpatient Pharmacy – Lobby Level, N.C. Cancer Hospital
- UNC Medical Center Employee Pharmacy – Lobby Level, N.C. Memorial Hospital