If you just had surgery, would you avoid taking strong painkillers for fear of becoming addicted? At a recent Sunnybrook Speaker Series, 55% of those attending this public lecture said “yes”. At first this may seem like the healthier option. Opioid addiction is, after all, a growing health concern.
That’s the headline most people are familiar with. People like Pat O’Halloran. At 72, she had led a healthy and active life and never needed to take medications. So following a recent hip replacement, she was wary of continuing with her course of prescribed opioids. “You hear horror stories about people becoming totally addicted to pain meds, so I thought I don’t want that to happen to me, so I will try to reduce the amount of pain medication as quickly as possible.”
Her family disagreed. So did her health care team when she contacted them with her concerns. “[They] explained to me it was essential that I maintain the dosage they had given to me because I have to do my physio twice a day. And I would not be able to tolerate doing the physio if I didn’t take the pain medication.” Pat listened. She worked hard every day to resume her movement and took her pills as prescribed. Several weeks after surgery, she was done her pain medication, and back to doing all of the activities she did before.
I spoke with several members of Pat’s health care team, and they all said the same thing: hip replacement surgery can only go so far. Patients have to put in the physical work every day to regain strength and mobility, and they can’t do that if they are hurting. Even if they’ve never taken medications before, having a major surgery changes things. Some patients may need to take opioid drugs up to six weeks to help physiotherapy efforts during rehabilitation.
The risk of becoming addicted to a pain medication is around 1%. There is a risk. But there are also safeguards in the hospital environment to do what’s possible to prevent that. At Sunnybrook’s Holland Orthopaedic & Arthritic Centre – where Pat had her surgery – the health care team is on the alert for red flags. Like if a patient’s need for pain medication doesn’t decrease over time. Patients at the Holland Centre are also given pain medications at the bedside and left to decide how much they need. Interestingly, this has actually led to a decrease in opioid use following surgery.
I recently asked a number of top Sunnybrook physicians for their best piece of health advice. Emergency physician Dr. Clare Atzema had this to say: “Don’t be afraid of medication. Medications are powerful, and when treated with respect and care, can be life changing in a positive way. While I used to avoid even taking acetaminophen, I realize now how wonderful it is that we have access to medications that can actually improve our health and quality of life.”