Shatterproof is proud to partner with Pacira Pharmaceuticals on Choices Matter, a campaign to help consumers make informed choices about pain management before, during, and after surgery. When it comes to planning your recovery from surgery, choices do matter. Doctors often prescribe opioids for pain relief, and while these drugs can sometimes be appropriate for short-term, acute pain, they can also be addictive.1

Over-prescribing of opioids after surgery is helping to fuel the opioid crisis in America.

If physicians reduced the number of opioid prescriptions written each year by 10%, it would result in:

After surgery, there are a wide range of medications available for treating post-surgical pain. Get to know your options, and talk with your doctor before surgery to create your custom pain management plan.

Concerns about Pain Management After Surgery

Whether you’re facing a knee replacement, back surgery, or your child is having a surgical procedure like wisdom teeth removal, you will most likely have many concerns – and pain management ranks high on that list. In fact, concerns about pain and how to manage it after surgery are some of the primary reasons patients choose to delay their procedures.

More than one-third of patients delayed a surgical procedure -- of those who delayed, their primary reasons included:

These concerns are valid, particularly in light of America’s opioid crisis. Over 33,000 Americans died of an opioid overdose in 2015. Roughly 83% of heroin users began using prescription pain killers first.

Many Americans are first introduced to opioids as a way to manage pain after surgery. Roughly 56 million patients are prescribed opioid medications after surgery each year, and nearly three million patients – or one in 10 – are still using opioids three to six months after their postsurgical recoveries.

Women & Opioids

Women, in particular, are at high risk for persistent opioid use – or continuing to use the drug 90 to 180 days beyond the post-surgical recovery period. Women ages 40-59 receive the most opioid prescriptions of any group – getting twice as many as men in the same age range. On average:

  • Women receive 30% more opioid prescriptions than men
  • 40% more women than men become persistent opioid users following surgery
  • The highest risk of persistent opioid use among any group for any procedure is 23% for women ages 35-44 who have knee replacement surgery
Opioid Use by Age & Gender

From Prescription to Addiction

For 15 years, Shatterproof Ambassador Britt Doyle’s wife would do anything to get her opioid prescription filled. Her addiction ended in death from an overdose.

Read More

Talking to Your Doctor

In order to successfully manage your pain while minimizing addiction risks, it is imperative to discuss all of your options with your doctor. In a Wakefield Research survey of 200 US orthopedic and soft tissue surgeons, 91% reported feeling pressure to prescribe opioids, and 70% said their patients asked for specific opioids by name.

In the same Wakefield Research survey, 500 patients who received orthopedic or soft tissue surgery reported their doctors didn’t discuss non-opioid options or the risks associated with taking opioids after surgery.

However, both doctors and patients indicated they’re receptive to other options.

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Doctor Discussion guide

Use the “Create My Guide” tool to save or print a PDF to bring to your next appointment to discuss your personal concerns about pain with your doctor.

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Pain Treatment—Why the Right Plan Matters

Of course, pain control is important not just for your comfort, but also to speed your healing, avoid complications, and prevent post-op pain from becoming chronic (long-term pain that can be difficult to manage). No two people experience pain the same way, and there are many factors that impact how much pain you feel. Some are physical and some are psychological, but they’re all very real. In some cases, opioids are a necessary and appropriate option to manage your short-term or acute pain – but understanding all of your options is the first step in creating your pain management plan.

Pain Medications Administered During Surgery

Anesthetics
Anesthetics such as lidocaine and bupivacaine are numbing medications that can be injected during surgery to manage pain. Anesthetics are injected directly into the surgical site to numb the area and provide local pain relief where the surgery occurred for anywhere from a few hours to a few days after the procedure. If your surgeon wants to prolong the effect, he or she may administer a long-lasting version that slowly releases the numbing medication over time to last as long as the most severe postsurgical discomfort. The novocaine used by your dentist to numb your mouth before you have a tooth pulled or a filling put in works the same way.

Oral Medications to Manage Post-Surgery Pain

  • Opioids
    Opioids are powerful painkillers that contain opiates as the active ingredient. They include medications like Vicodin, OxyContin, Percocet, and codeine, among others. These drugs can be safe and effective if taken properly for a short period of time, but when prescribed improperly or taken incorrectly or for too long, it’s possible to become dependent on or addicted to opioids.
  • Non-opioids
    Non-opioid painkillers contain active ingredients like aspirin, acetaminophen, or a non-steroidal anti-inflammatory (NSAID). They include medications like Advil, Tylenol, naproxen, and ibuprofen, along with others. Many of these drugs are available over the counter without a prescription, although heavier doses of some NSAID treatments require a prescription. While generally considered safe, each of these medications carry their own specific sets of risks.

There are a wide range of treatment options after surgery – and they aren’t limited to oral painkillers. They also include everything from anesthetics to complementary medicine and even alternative medicine options. Learn more about different pain management options before you create your plan. By varying the types of pain medicines used, your doctor can avoid exposing you to very high doses of any one medication, which can help reduce your chances of experiencing side effects.

Ways to Reduce Opioid Risk

If you and your doctor decide to include opioids in your treatment plan, you can find steps for how you and your physician can reduce your risks of becoming addicted below. Less than 40% of surgeons surveyed implemented these steps, so it’s up to you to be proactive and talk with your doctor. Remember, your choices matter!

Pain Management Checklist

Download the checklist below

[ ] Bring your caregiver to meetings with your doctor about pain management
[ ] Ask your doctor for counseling on the potential dangers of medication
[ ] Create a “pain contract” with your doctor, which documents the pain medications you’ll use, the risks associated, and other terms
[ ] Ask if a lower dosage is right for you
[ ] Ask if you should start with a shorter prescription or fewer pills
[ ] Ask about non-opioid options
[ ] Ask about multimodal pain management – which includes a variety of pain treatments and uses fewer opioids

In addition to these ideas, always take your medication exactly as prescribed by your doctor, and never take prescriptions for longer than absolutely necessary.

Pill Disposal

There were over 3.3 billion unused post-surgical opioids prescribed in 2016, and many of those pills flood into communities and fuel the opioid crisis. To prevent your prescription drugs from being diverted for non-medical use, dispose of any remaining pills in your prescription. FDA guidelines for proper medical disposal recommend that you:

  • Read your medication label for proper disposal
  • Do not flush pills or dump medication down the sink unless directed by the label
  • Find a community drug take back program where you can drop off unused pills
  • If there are no directions on the label and a take back program is not available, dispose of drugs in the trash by removing them from the original bottle and mixing them with an undesirable product (like coffee grounds or kitty litter) and sealing the mixture in a bag or other leak-proof container.

To learn more about things you can do to build your plan for before, during, and after surgery, visit planagainstpain.com.

REFERENCE
1. The United States for Non-Dependence: An Analysis of the Impact of Opioid Overprescribing in America