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Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

+1 Some of the people on this thread don't have the ability to handle a hangnail without meds that were designed for end-of-life cancer patients.

What if you were okay? What if everything was fine? What if you barely needed the tylenol, healed beautifully, and it wasn't even an issue?

If you’re ok, then you don’t take the pain meds, obviously. I’m single. If I don’t have things at home after a surgery, I wont be able to get them until at least the next day, if I can get a friend to run an errand for me. (Would they even be able to pick up a narcotic for me? I don’t know.) But it drives me crazy how doctors hand you a paper prescription as you’re leaving surgery rather than letting you get everything that’s anticipate-able squared away beforehand.

Narcotic prescriptions often need to have actual signatures, be presented in person, be picked up by a party 18 and older... That's still not a good reason to hand them out in advance of actual need "just in case". They're not "have on hand in case you need it" meds. That's tylenol. They're "special circumstance that justifies jumping through additional hoops" meds, and responsible people should expect that if they want access.

No, no, no, no, no. If the block I was given has worn off by 1am and I am alone with my 6-year-old son, I have no way of getting an RX IN THE MIDDLE OF THE NIGHT to alleviate horrendous pain. Why would you expect me, who knows my body, to suffer because of your addiction issues? 2-3 pills as part of the prep is not feeding addiction, FFS.

Horrendous pain and suffering? You can take tylenol and ibuprofen simultaneously to cut that to a manageable level, and then staggered to maintain pain coverage and avoid breakthrough pain. Be honest: 2-3 pills is a recreational dose.

If you're having the kind of pain that would truly necessitate opioid use, you need to talk to your doctor about why.

Oh you mean telling the doctor that I know my body better than they do and will need pain medication, like OP said she would like to have the option for? But you seem hellbent on just “toughing it out” like a cowboy because, why?

And 2-3 pills will get you through the night until you can speak to your surgeon versus the on-call physician. Or maybe all that is needed to get over the hump where only ibuprofen is needed.

Responsible people know how to prepare for surgery and have the a good understanding how they would like to have their pain managed. We all aren’t recovering addicts or freaking sheep.

Why would people in the US undergoing surgery be so very different from those undergoing surgery in Sweden, Germany, France, and the UK? What about Americans makes them need opioids when those in other countries do not, even after the same surgeries?

Americans expect service, comfort, and ease. It's a cultural thing. Where people in other places might reasonably expect post-surgical discomfort and modify their schedules and expectations accordingly, americans can't deal with pain or inconvenience, and need to micromanage professionals to get what they think they need upfront, just in case.

Overall health outcomes here suck proportionally, yet cost more because of insurance regulations, jumpy docs who are reluctant to prescribe, malpractice suits, etc.

I have chronic pain that is horrific. Do you have any concept of serious pain that will not go away. Its soul sucking and very hard to live with. I don't do pain meds as doctors will not treat you if you don't but I'm basically confined to my house at this point. You don't really understand that kind of pain if you minimize it. I cannot take ibprohen anymore regularly as it did a lot of damage to my kidney's doing it daily. Tylenol does nothing.

Nah, I'm the sober chronic pain person who got flamed upthread. I get it, and I disagree. Mentality is a huge part of pain perception. I've been confined to my home at times too, and I get the psychological complications of isolation and being left out and being misunderstood, etc.

Opiates don't fix any part of that.

You’re a fd up addict. This poster isn’t 🤷

You're a horrible person, addicted to cruelty. Enjoy your L.

There is a lot of physical dependence and misuse without psychological addiction. The only concern with opioids isn't overdose and addictions (in the stereotypical way that people think of addictions).

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Anonymous wrote:I met with a surgeon today for a consult for significant and urgent surgery. There were a number of things I was unimpressed with but one was that they only give Tylenol. I feel like they would probably give more if a patient was in REALLY bad shape but her take was “some discomfort is normal after major surgery but it should be manageable with Tylenol.” That’s jacked up. We invented medication so that you don’t have to feel pain. Give a patient 3-5 days of pain meds. I’m meeting with other surgeons because this one seems heartless.

Apparently your surgery isn't that urgent.

Quit doctor shopping for drugs. Tylenol and ibuprofen will mitigate most pain. Neither has significant side effects, withdrawal symptoms, addiction potential or other complications. You don't need 3-5 days of narcotics, and if you do, you can be prescribed them when you need them. Demanding drugs you probably won't need in advance is drug-seeking behavior. No, you should not have an expectation of 'zero pain' post-surgery. You should anticipate and prepare for discomfort at a level commensurate with whatever procedure you're having done, and be with it for the brief time it's present because that's life in a body. I would strongly suggest you avoid opioids like the plague they are, as the withdrawals kick in after even short-term use, and 3-5 days is more than enough to trigger addiction.

-long-term chronic pain patient who has BTDT with pretty much all of the painkiller options

Asking for pain medication after major surgery is not “drug seeking behavior.” People have lost their minds!

One thing I have always noted on DCUM is the purist mentality; it is so toxic. Pain meds work! There is no prize at the end for enduring crippling pain after a c-section, hysterectomy, bunion removal, or thyroidectomy.

And I am sick of doctors telling me THEY know my body better than I DO. I see no reason to suffer because someone somewhere is addicted to something. Change surgeons and don't look back OP. If you get home from surgery with only Tylenol and have crippiling pain at 2 am, it will be unnecessarily effing miserable getting relief, trust me, I know.

Agreed. And it’s damn clear that one or more posters are in fact opioid addicts (“chronic pain patient”) who are eager to see their own flaws and failures in everyone else.

Y'all would rather start attacking people you don't even know than listen and read and learn.

I've been totally sober for years, sweetie. If you're mad about me trying to prevent someone from walking the road to hell I managed to make it through, well, that's something for you to take up with your medical professionals (though if they've found a cure for being an inflammed and irritable ass on the internet, I don't know about it). Best of luck to you.

It’s interesting. The people I know who are serious about sobriety would not be addressing another person this way. Maybe they are unusual.

If they’re not acting like this thing up there, maybe they’re not yet um “totally sober.”

She’s the equivalent of a dry drunk inching closer to a barstool.

Thing? One in one's cups thus shouldn't speak or post. Trash.

“Totally sober.” It’s not going well for you, jeez.

OP will be fine. Good luck with the tooth retention, sweetie.

What are you even talking about? Maybe try sobering up before you comment again. Tooth retention? You make zero sense.

You’re methy, sweetie. Very methy. Good luck after the inevitable OD.

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Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

+1 Some of the people on this thread don't have the ability to handle a hangnail without meds that were designed for end-of-life cancer patients.

What if you were okay? What if everything was fine? What if you barely needed the tylenol, healed beautifully, and it wasn't even an issue?

If you’re ok, then you don’t take the pain meds, obviously. I’m single. If I don’t have things at home after a surgery, I wont be able to get them until at least the next day, if I can get a friend to run an errand for me. (Would they even be able to pick up a narcotic for me? I don’t know.) But it drives me crazy how doctors hand you a paper prescription as you’re leaving surgery rather than letting you get everything that’s anticipate-able squared away beforehand.

Narcotic prescriptions often need to have actual signatures, be presented in person, be picked up by a party 18 and older... That's still not a good reason to hand them out in advance of actual need "just in case". They're not "have on hand in case you need it" meds. That's tylenol. They're "special circumstance that justifies jumping through additional hoops" meds, and responsible people should expect that if they want access.

No, no, no, no, no. If the block I was given has worn off by 1am and I am alone with my 6-year-old son, I have no way of getting an RX IN THE MIDDLE OF THE NIGHT to alleviate horrendous pain. Why would you expect me, who knows my body, to suffer because of your addiction issues? 2-3 pills as part of the prep is not feeding addiction, FFS.

Horrendous pain and suffering? You can take tylenol and ibuprofen simultaneously to cut that to a manageable level, and then staggered to maintain pain coverage and avoid breakthrough pain. Be honest: 2-3 pills is a recreational dose.

If you're having the kind of pain that would truly necessitate opioid use, you need to talk to your doctor about why.

Oh you mean telling the doctor that I know my body better than they do and will need pain medication, like OP said she would like to have the option for? But you seem hellbent on just “toughing it out” like a cowboy because, why?

And 2-3 pills will get you through the night until you can speak to your surgeon versus the on-call physician. Or maybe all that is needed to get over the hump where only ibuprofen is needed.

Responsible people know how to prepare for surgery and have the a good understanding how they would like to have their pain managed. We all aren’t recovering addicts or freaking sheep.

Why would people in the US undergoing surgery be so very different from those undergoing surgery in Sweden, Germany, France, and the UK? What about Americans makes them need opioids when those in other countries do not, even after the same surgeries?

Americans expect service, comfort, and ease. It's a cultural thing. Where people in other places might reasonably expect post-surgical discomfort and modify their schedules and expectations accordingly, americans can't deal with pain or inconvenience, and need to micromanage professionals to get what they think they need upfront, just in case.

Overall health outcomes here suck proportionally, yet cost more because of insurance regulations, jumpy docs who are reluctant to prescribe, malpractice suits, etc.

I have chronic pain that is horrific. Do you have any concept of serious pain that will not go away. Its soul sucking and very hard to live with. I don't do pain meds as doctors will not treat you if you don't but I'm basically confined to my house at this point. You don't really understand that kind of pain if you minimize it. I cannot take ibprohen anymore regularly as it did a lot of damage to my kidney's doing it daily. Tylenol does nothing.

Nah, I'm the sober chronic pain person who got flamed upthread. I get it, and I disagree. Mentality is a huge part of pain perception. I've been confined to my home at times too, and I get the psychological complications of isolation and being left out and being misunderstood, etc.

Opiates don't fix any part of that.

You’re a fd up addict. This poster isn’t 🤷

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:With knee replacement surgery they tell you to get ahead of the pain.
My DH tried to skip the heavy duty pain meds and it was not pretty for a few days.

He definitely needed the stronger drugs.

This. I've had a lot of different surgeries, and my pain management needs have been quite different in each case. My ACL/MCL/meniscus repair was the worst, and I definitely needed the oxy for about 4 days post-op and multiple nights after that. My bilateral mastectomy wasn't too bad, and I was fine with gabapentin and tylenol/ibuprofen. They might have given me a vicodin or two while I was still in the hospital, but nothing to take home after I was released. Laparoscopic surgeries were trivial, and OTC meds were completely fine.

OP didn't tell us what the surgery is, so we have no idea whether the doctor is being reasonable with the pain meds or whether he's some sort of purist. I would run far from any orthopedic surgeon who thinks OTC meds are sufficient.

You think doctors don't know this? The fact that OP didn't say, and hasn't come back to clarify, strongly suggests they already know they're on some nonsense.

OP probably saw the people ganging up on her and accusing her of being addicted. It is a fact that some doctors are extremely rigid when it comes to pain management. Check out r/medicine and see the debates among physicians about this. Besides not knowing what the surgery is, we don't know whether OP has even undergone surgical procedures before.

OP was probably trolling, like most of the people who post here. Either that, or they wanted "support" and bounced when they got a perspective check instead.

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Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

+1 Some of the people on this thread don't have the ability to handle a hangnail without meds that were designed for end-of-life cancer patients.

What if you were okay? What if everything was fine? What if you barely needed the tylenol, healed beautifully, and it wasn't even an issue?

If you’re ok, then you don’t take the pain meds, obviously. I’m single. If I don’t have things at home after a surgery, I wont be able to get them until at least the next day, if I can get a friend to run an errand for me. (Would they even be able to pick up a narcotic for me? I don’t know.) But it drives me crazy how doctors hand you a paper prescription as you’re leaving surgery rather than letting you get everything that’s anticipate-able squared away beforehand.

Narcotic prescriptions often need to have actual signatures, be presented in person, be picked up by a party 18 and older... That's still not a good reason to hand them out in advance of actual need "just in case". They're not "have on hand in case you need it" meds. That's tylenol. They're "special circumstance that justifies jumping through additional hoops" meds, and responsible people should expect that if they want access.

No, no, no, no, no. If the block I was given has worn off by 1am and I am alone with my 6-year-old son, I have no way of getting an RX IN THE MIDDLE OF THE NIGHT to alleviate horrendous pain. Why would you expect me, who knows my body, to suffer because of your addiction issues? 2-3 pills as part of the prep is not feeding addiction, FFS.

Horrendous pain and suffering? You can take tylenol and ibuprofen simultaneously to cut that to a manageable level, and then staggered to maintain pain coverage and avoid breakthrough pain. Be honest: 2-3 pills is a recreational dose.

If you're having the kind of pain that would truly necessitate opioid use, you need to talk to your doctor about why.

Oh you mean telling the doctor that I know my body better than they do and will need pain medication, like OP said she would like to have the option for? But you seem hellbent on just “toughing it out” like a cowboy because, why?

And 2-3 pills will get you through the night until you can speak to your surgeon versus the on-call physician. Or maybe all that is needed to get over the hump where only ibuprofen is needed.

Responsible people know how to prepare for surgery and have the a good understanding how they would like to have their pain managed. We all aren’t recovering addicts or freaking sheep.

Why would people in the US undergoing surgery be so very different from those undergoing surgery in Sweden, Germany, France, and the UK? What about Americans makes them need opioids when those in other countries do not, even after the same surgeries?

Americans expect service, comfort, and ease. It's a cultural thing. Where people in other places might reasonably expect post-surgical discomfort and modify their schedules and expectations accordingly, americans can't deal with pain or inconvenience, and need to micromanage professionals to get what they think they need upfront, just in case.

Overall health outcomes here suck proportionally, yet cost more because of insurance regulations, jumpy docs who are reluctant to prescribe, malpractice suits, etc.

I have chronic pain that is horrific. Do you have any concept of serious pain that will not go away. Its soul sucking and very hard to live with. I don't do pain meds as doctors will not treat you if you don't but I'm basically confined to my house at this point. You don't really understand that kind of pain if you minimize it. I cannot take ibprohen anymore regularly as it did a lot of damage to my kidney's doing it daily. Tylenol does nothing.

Nah, I'm the sober chronic pain person who got flamed upthread. I get it, and I disagree. Mentality is a huge part of pain perception. I've been confined to my home at times too, and I get the psychological complications of isolation and being left out and being misunderstood, etc.

Opiates don't fix any part of that.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:With knee replacement surgery they tell you to get ahead of the pain.
My DH tried to skip the heavy duty pain meds and it was not pretty for a few days.

He definitely needed the stronger drugs.

This. I've had a lot of different surgeries, and my pain management needs have been quite different in each case. My ACL/MCL/meniscus repair was the worst, and I definitely needed the oxy for about 4 days post-op and multiple nights after that. My bilateral mastectomy wasn't too bad, and I was fine with gabapentin and tylenol/ibuprofen. They might have given me a vicodin or two while I was still in the hospital, but nothing to take home after I was released. Laparoscopic surgeries were trivial, and OTC meds were completely fine.

OP didn't tell us what the surgery is, so we have no idea whether the doctor is being reasonable with the pain meds or whether he's some sort of purist. I would run far from any orthopedic surgeon who thinks OTC meds are sufficient.

You think doctors don't know this? The fact that OP didn't say, and hasn't come back to clarify, strongly suggests they already know they're on some nonsense.

OP probably saw the people ganging up on her and accusing her of being addicted. It is a fact that some doctors are extremely rigid when it comes to pain management. Check out r/medicine and see the debates among physicians about this. Besides not knowing what the surgery is, we don't know whether OP has even undergone surgical procedures before.

Anonymous wrote:

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

+1 Some of the people on this thread don't have the ability to handle a hangnail without meds that were designed for end-of-life cancer patients.

What if you were okay? What if everything was fine? What if you barely needed the tylenol, healed beautifully, and it wasn't even an issue?

If you’re ok, then you don’t take the pain meds, obviously. I’m single. If I don’t have things at home after a surgery, I wont be able to get them until at least the next day, if I can get a friend to run an errand for me. (Would they even be able to pick up a narcotic for me? I don’t know.) But it drives me crazy how doctors hand you a paper prescription as you’re leaving surgery rather than letting you get everything that’s anticipate-able squared away beforehand.

Narcotic prescriptions often need to have actual signatures, be presented in person, be picked up by a party 18 and older... That's still not a good reason to hand them out in advance of actual need "just in case". They're not "have on hand in case you need it" meds. That's tylenol. They're "special circumstance that justifies jumping through additional hoops" meds, and responsible people should expect that if they want access.

No, no, no, no, no. If the block I was given has worn off by 1am and I am alone with my 6-year-old son, I have no way of getting an RX IN THE MIDDLE OF THE NIGHT to alleviate horrendous pain. Why would you expect me, who knows my body, to suffer because of your addiction issues? 2-3 pills as part of the prep is not feeding addiction, FFS.

Horrendous pain and suffering? You can take tylenol and ibuprofen simultaneously to cut that to a manageable level, and then staggered to maintain pain coverage and avoid breakthrough pain. Be honest: 2-3 pills is a recreational dose.

If you're having the kind of pain that would truly necessitate opioid use, you need to talk to your doctor about why.

Oh you mean telling the doctor that I know my body better than they do and will need pain medication, like OP said she would like to have the option for? But you seem hellbent on just “toughing it out” like a cowboy because, why?

And 2-3 pills will get you through the night until you can speak to your surgeon versus the on-call physician. Or maybe all that is needed to get over the hump where only ibuprofen is needed.

Responsible people know how to prepare for surgery and have the a good understanding how they would like to have their pain managed. We all aren’t recovering addicts or freaking sheep.

Why would people in the US undergoing surgery be so very different from those undergoing surgery in Sweden, Germany, France, and the UK? What about Americans makes them need opioids when those in other countries do not, even after the same surgeries?

Americans expect service, comfort, and ease. It's a cultural thing. Where people in other places might reasonably expect post-surgical discomfort and modify their schedules and expectations accordingly, americans can't deal with pain or inconvenience, and need to micromanage professionals to get what they think they need upfront, just in case.

Overall health outcomes here suck proportionally, yet cost more because of insurance regulations, jumpy docs who are reluctant to prescribe, malpractice suits, etc.

I have chronic pain that is horrific. Do you have any concept of serious pain that will not go away. Its soul sucking and very hard to live with. I don't do pain meds as doctors will not treat you if you don't but I'm basically confined to my house at this point. You don't really understand that kind of pain if you minimize it. I cannot take ibprohen anymore regularly as it did a lot of damage to my kidney's doing it daily. Tylenol does nothing.

Anonymous wrote:

Anonymous wrote:With knee replacement surgery they tell you to get ahead of the pain.
My DH tried to skip the heavy duty pain meds and it was not pretty for a few days.

He definitely needed the stronger drugs.

This. I've had a lot of different surgeries, and my pain management needs have been quite different in each case. My ACL/MCL/meniscus repair was the worst, and I definitely needed the oxy for about 4 days post-op and multiple nights after that. My bilateral mastectomy wasn't too bad, and I was fine with gabapentin and tylenol/ibuprofen. They might have given me a vicodin or two while I was still in the hospital, but nothing to take home after I was released. Laparoscopic surgeries were trivial, and OTC meds were completely fine.

OP didn't tell us what the surgery is, so we have no idea whether the doctor is being reasonable with the pain meds or whether he's some sort of purist. I would run far from any orthopedic surgeon who thinks OTC meds are sufficient.

You think doctors don't know this? The fact that OP didn't say, and hasn't come back to clarify, strongly suggests they already know they're on some nonsense.

Anonymous wrote:With knee replacement surgery they tell you to get ahead of the pain.
My DH tried to skip the heavy duty pain meds and it was not pretty for a few days.

He definitely needed the stronger drugs.

This. I've had a lot of different surgeries, and my pain management needs have been quite different in each case. My ACL/MCL/meniscus repair was the worst, and I definitely needed the oxy for about 4 days post-op and multiple nights after that. My bilateral mastectomy wasn't too bad, and I was fine with gabapentin and tylenol/ibuprofen. They might have given me a vicodin or two while I was still in the hospital, but nothing to take home after I was released. Laparoscopic surgeries were trivial, and OTC meds were completely fine.

OP didn't tell us what the surgery is, so we have no idea whether the doctor is being reasonable with the pain meds or whether he's some sort of purist. I would run far from any orthopedic surgeon who thinks OTC meds are sufficient.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

You didn’t read the post. More doctors will prescribe additional pain medications. If some continues to experience pain beyond what otc meds can handle. But they don’t just send every patient home with bottles of narcotics benzos just in case they have pain or anxiety. It is shopping around as OP doesn’t even have any pain yet and that pain may be well managed with otc. Just because the current culture is to pop pills for everything and feel nothing mentally or physically doesn’t mean that approach is supported by the medical field. It has led to massive amounts of lives ruined in the past and just isn’t modern medicine. The approach now is to treat the patient and their individual needs, not to hand out bottles of narcotics and benzos to anyone who wants them just in case they have pain that isn’t managed with otc.

DP. Pain is better managed when you get ahead of it, and a pain Rx (for a short duration) often will be called in during the time of major surgery, before the patient heads home, for that reason. Refills are not automatic, but often will be filled after a detailed discussion with the health practice.

The current view is not opposed to offering these meds; in fact the pendulum is very carefully swinging back due to doctors’ concerns about how poorly pain has been managed for their patients over the past decade as a result of the severe limits on opioids.

Again, pain is very individual and procedures affect people differently.

Some of you are actually posting out-of-date and incorrect info, with a dollop of proselytizing on top.

Not out of date or incorrect care. I guess it is different approaches. Where I am we provide individualized, patient centered care which means that having surgery isnt' an automatic narcotics and benzo script for everyone. I am surpised your doctors still hand it out like candy and don't take a more controlled or individualized approach and that surgery = whatever you want for pain before the pain even happens. Pain management is important but where I work, there is no longer the view that narcotics are the only option for pain management. We have a chronic pain clinic that doesn't even prescribe narcotics. There are many ways to manage pain and using narcotics as your solution for every patient who has surgery without any assessment of the individual or their need led to major addiction, overuse and dependency issues. I would say that your approach is more old school - to not recognize the harms of opioids and the dangers of overprescribing and using them broadly for all patients who are surgical patients.

In the healthcare network we use, the pain clinics do not do opioids because opioid management is done by the PCP (for chronic pain). My son had a back injury several years ago, had surgery, but then had a reherniation of the disk that was ruptured the first time. Because our system would not do disk replacement (and it was essentially an HMO, same company sold the insurance and owned the providers) he waited until he could change insurance providers to get that instead of fusion. The pain clinic handled steroid injections, the PCP handled the opioid contract. Incidentally, despite being on very high doses of opioid and non-opioid drugs for pain for more than a year, he had no difficulty going off them as he recovered from surgery.

There are researchers who challenge the idea that prescription opioids caused the epidemic; contrary to the popular myth, most addicts and most overdoses did not start with drugs prescribed for them. (However, most people never use all the opioids they are prescribed, so leftover meds have been a source for non-medical use of opioids, often by someone other than the person the drugs were originalyl prescribed for).

There are doctors who refuse to give opioids after surgery (although unless you are sensitive to NSAIDs IV toradol, which is an NSAID, is apparently pretty effective).

There are also a lot of doctors who believe that the reaction to the opioid problem has made things much worse in terms of patient care and managing pain.

I had wrist surgery after a bad fall (couple of plates and a lot of screws) and the first night was agony even with whatever the opioid was(might have been hydrocodone). I ended up not need all the pills they gave me but would not have wanted to be without. When I had wisdom teeth removed I was given codeine (many years ago) but was going to my parents' for the weekend and forgot the pills. Not as bad as the wrist thing but I mostly slept as much as possible because I was so sore.

Which doctor is “reluctant” to prescribe?
None.

Anonymous wrote:

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Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

+1 Some of the people on this thread don't have the ability to handle a hangnail without meds that were designed for end-of-life cancer patients.

What if you were okay? What if everything was fine? What if you barely needed the tylenol, healed beautifully, and it wasn't even an issue?

If you’re ok, then you don’t take the pain meds, obviously. I’m single. If I don’t have things at home after a surgery, I wont be able to get them until at least the next day, if I can get a friend to run an errand for me. (Would they even be able to pick up a narcotic for me? I don’t know.) But it drives me crazy how doctors hand you a paper prescription as you’re leaving surgery rather than letting you get everything that’s anticipate-able squared away beforehand.

Narcotic prescriptions often need to have actual signatures, be presented in person, be picked up by a party 18 and older... That's still not a good reason to hand them out in advance of actual need "just in case". They're not "have on hand in case you need it" meds. That's tylenol. They're "special circumstance that justifies jumping through additional hoops" meds, and responsible people should expect that if they want access.

No, no, no, no, no. If the block I was given has worn off by 1am and I am alone with my 6-year-old son, I have no way of getting an RX IN THE MIDDLE OF THE NIGHT to alleviate horrendous pain. Why would you expect me, who knows my body, to suffer because of your addiction issues? 2-3 pills as part of the prep is not feeding addiction, FFS.

Horrendous pain and suffering? You can take tylenol and ibuprofen simultaneously to cut that to a manageable level, and then staggered to maintain pain coverage and avoid breakthrough pain. Be honest: 2-3 pills is a recreational dose.

If you're having the kind of pain that would truly necessitate opioid use, you need to talk to your doctor about why.

Oh you mean telling the doctor that I know my body better than they do and will need pain medication, like OP said she would like to have the option for? But you seem hellbent on just “toughing it out” like a cowboy because, why?

And 2-3 pills will get you through the night until you can speak to your surgeon versus the on-call physician. Or maybe all that is needed to get over the hump where only ibuprofen is needed.

Responsible people know how to prepare for surgery and have the a good understanding how they would like to have their pain managed. We all aren’t recovering addicts or freaking sheep.

Why would people in the US undergoing surgery be so very different from those undergoing surgery in Sweden, Germany, France, and the UK? What about Americans makes them need opioids when those in other countries do not, even after the same surgeries?

Americans expect service, comfort, and ease. It's a cultural thing. Where people in other places might reasonably expect post-surgical discomfort and modify their schedules and expectations accordingly, americans can't deal with pain or inconvenience, and need to micromanage professionals to get what they think they need upfront, just in case.

Overall health outcomes here suck proportionally, yet cost more because of insurance regulations, jumpy docs who are reluctant to prescribe, malpractice suits, etc.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Wanting narcotics before the surgery even happens and there is pain, and shopping around to find someone who freely gives them out is a pretty big red flag. A lot of docs now only use them in a very controlled way for people whose pain isn’t managed in other ways. They don’t just send people home with bottles of narcotics anymore for just in case reasons.

No this is not a red flag at all. Not wanting to endure pain because one doctor thinks it’s fine for you to suffer when there is a different doctor that will make recovery bearable is not drug shopping.

History has taught us it is crueler and does more harm to patients to give narcotics out without an individualized need than it is to ask patient to try and manage their pain initially with OTC and request stronger meds if needed.

+1 Some of the people on this thread don't have the ability to handle a hangnail without meds that were designed for end-of-life cancer patients.

What if you were okay? What if everything was fine? What if you barely needed the tylenol, healed beautifully, and it wasn't even an issue?

If you’re ok, then you don’t take the pain meds, obviously. I’m single. If I don’t have things at home after a surgery, I wont be able to get them until at least the next day, if I can get a friend to run an errand for me. (Would they even be able to pick up a narcotic for me? I don’t know.) But it drives me crazy how doctors hand you a paper prescription as you’re leaving surgery rather than letting you get everything that’s anticipate-able squared away beforehand.

Narcotic prescriptions often need to have actual signatures, be presented in person, be picked up by a party 18 and older... That's still not a good reason to hand them out in advance of actual need "just in case". They're not "have on hand in case you need it" meds. That's tylenol. They're "special circumstance that justifies jumping through additional hoops" meds, and responsible people should expect that if they want access.

No, no, no, no, no. If the block I was given has worn off by 1am and I am alone with my 6-year-old son, I have no way of getting an RX IN THE MIDDLE OF THE NIGHT to alleviate horrendous pain. Why would you expect me, who knows my body, to suffer because of your addiction issues? 2-3 pills as part of the prep is not feeding addiction, FFS.

Horrendous pain and suffering? You can take tylenol and ibuprofen simultaneously to cut that to a manageable level, and then staggered to maintain pain coverage and avoid breakthrough pain. Be honest: 2-3 pills is a recreational dose.

If you're having the kind of pain that would truly necessitate opioid use, you need to talk to your doctor about why.

Oh you mean telling the doctor that I know my body better than they do and will need pain medication, like OP said she would like to have the option for? But you seem hellbent on just “toughing it out” like a cowboy because, why?

And 2-3 pills will get you through the night until you can speak to your surgeon versus the on-call physician. Or maybe all that is needed to get over the hump where only ibuprofen is needed.

Responsible people know how to prepare for surgery and have the a good understanding how they would like to have their pain managed. We all aren’t recovering addicts or freaking sheep.

Why would people in the US undergoing surgery be so very different from those undergoing surgery in Sweden, Germany, France, and the UK? What about Americans makes them need opioids when those in other countries do not, even after the same surgeries?