Staying Clean and Sober Through Surgery
If you’re facing surgery, it can be a scary thing. Not only do you have to deal with recovery, but you also have to deal with the aftermath of pain pills. For many of us, that can mean confronting past or current issues with substance abuse, because those pills can result in addiction, or in a relapse. That’s especially true because surgery can result in reduced mobility and quality of life for the recovery period – meaning you’re more likely to need an outlet and coping mechanisms.
Staying clean and sober through surgery can be challenging. However, millions of people do it every year. While there is a very real risk of addiction following surgery, you can talk with your doctor, understand risks, and create a plan for yourself that keeps you as far away from drugs and alcohol as possible.
Planning for a Surgery
The first step to preparing for managing substance use around your surgery is to discuss your concerns with the doctor in question. Here, you can share concerns about pain medication, a past history with substance abuse, or any other relevant details. Doctors and surgeons are more than used to helping patients with these kinds of issues. There’s nothing to be ashamed about if you’re worried and your doctor will understand and will offer insight and alternatives for you. For example, depending on your surgery, you might be recommended into alternative pain management schedules. Here, you receive more checkups, more maintenance, and more attention to how much of a drug you’re taking and why. It’s also increasingly common to offer a few days of a high-strength pain-reliever with opioids and then switch to prescription-strength Tylenol within 2-14 days. This means you’ll have to experience more pain, but it can greatly reduce the chances of dependence and addiction.
In high-risk cases, for example if you’re currently receiving treatment for substance abuse, you might actually be kept in the hospital for the duration of the pain medication. When you leave the hospital, you’ll be clean and sober, and you’ll have a prescription for Tylenol.
If you’ve been prescribed pain pills after surgery, it can be challenging to manage. That’s especially true if you also struggle with other substances or opioids.
- Ask for extra checkups. Your doctor and nurses will be happy to oblige unless your area is too busy to allow that extra care.
- Only take pain pills when you’re in pain. It’s probably a good idea to take pills as recommended for the first 2-4 days. Afterwards, you can try waiting to take them until you start to feel pain. While that’s not a good idea with major surgery, for many minor surgeries, that’s more than enough.
- Switch to NSAIDs as soon as possible. Depending on your surgery, you can switch to an NSAID such as prescription-strength Tylenol within 2-14 days post-surgery. That reduces your exposure to tolerance and addiction-inducing drugs.
It’s also important to keep in mind that you can always ask for help. If you don’t trust yourself with pain medication, as a family member to keep your pills and help you take them on schedule. Or, ask to stay in assisted living for the duration of recovery.
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Reducing Pain without Pills
There are plenty of ways to manage pain without drugs and alcohol. While none of them will be as effective as simply numbing pain, they can be very effective over the long-term and will also work to improve your quality of life. Importantly, you’ll always have to wait until surgery recovery progresses far enough to enable you to lean on those coping mechanisms.
Exercise/Physical Therapy – Exercise reduces pain while improving pain tolerance. Endorphins and hormones like dopamine relax the muscles and act as natural pain relievers. People who start physical therapy shortly after surgery report less pain while taking fewer painkillers. Of course, your options will depend on the surgery you’re getting, your health, and even your insurance. However, the sooner you get into physical therapy and exercise, the less you’ll have to rely on painkillers.
Therapy – While pain is a very real thing, our emotions and our experience of pain greatly impact how we feel about it. For that reason, cognitive behavioral therapy has been shown to be effective in reducing post-surgery pain by improving how people experience it. That means you have to rely less on drugs and alcohol and on escapism, because you have an easier time dealing with the pain you’re experiencing.
Stress Management – Stress worsens pain, causes you to need an outlet, and pushes many people to self-medication. That can result in abusing pain pills, in drinking, or in mixing drugs and alcohol during recovery. Stress management courses or therapy can help you to reduce that effect by improving how you experience stressful situations and by reducing the amount of stress you feel. In other cases, stress-reducing activities like meditation, doing something calming, exercise, or even taking a bath can actively release dopamine and other pain-relieving endorphins in the brain. This means stress management can reduce your reliance on drugs and alcohol in two ways.
Keeping Good Habits – Eventually, your lifestyle is going to have a large impact on your drug and alcohol reliance. If you’re going into surgery, it’s important to try to maintain good habits when you come out. That can mean eating a balanced diet, avoiding sugar and alcohol, getting light exercise once it’s possible, getting enough sleep, maintaining a healthy sleep schedule, and taking time to destress and relax. Depending on the surgery, your lifestyle and abilities may be severely handicapped. But, where necessary, you should make sure you have the help to maintain your home, to keep up with personal hygiene and grooming, and to ensure you can go outside and relax.
What to Do If You’re Struggling with Substance Use
If you’re coming out of surgery and are already struggling with using pain pills, alcohol, or a combination of the two, it’s important to ask for help. Most people with a post-surgery prescription for opioid medication will receive a Risk Evaluation and Mitigation Strategy or REMS. That strategy should involve checkups where you can talk with nurses or a counselor and get help if you’re struggling. Depending on how badly you’re struggling, that help may include more checkups and visits, moving into an assisted living facility, or moving into rehab.
Surgery can have a major impact on your recovery or your ability to stay clean and sober. However, it doesn’t have to. With good planning, by staying aware of your substance abuse, and by ensuring that you don’t rely on just painkillers for your recovery, you can avoid relapse or becoming addicted. Good luck with your surgery.
If you or a loved one is seeking help for alcohol or other substance abuse, contact us at Stairway Resource Center today. The Stairway Resource Center offers a 60 to 90-day outpatient program that takes place in a community setting. We offer dual diagnosis treatment and daily group and individual therapy for our clients.
Cristina is a bilingual clinical social worker with over 10 years experience working in the field of mental health and addiction, both in the non profit and private sectors. Cristina received a diploma as a certified substance abuse counselor before returning to school to receive a Masters Degree in Social work at USC. Cristina uses a client-centered trauma focused approach in her treatment modalities, blending evidenced based practices such as CBT and EMDR to create an individualized treatment plan to support each client’s unique needs.