Mild Pain and a Big, Post-Op Bundle of Oxycodone and Morphine – Really?

I just had a hip replacement - a surprisingly easy and comfortable surgery, as these things go. The staff had me walking the same day, and I was able to leave the hospital soon after, with only a mild ache in my leg – nothing a little Tylenol couldn’t handle, and, truth be told, I’d have been fine without the Tylenol, too.

(My physical therapist says she finds that about half the people who have this surgery find it a breeze. The other half are wired to experience significant pain. In terms of actual healing and recovery, however, it takes the same amount of time for both groups.) 

Nonetheless, my excellent surgeon discharged me from the hospital with 60 Oxycodone tablets (5 mg.), and 14 Morphine extended release tabs (15 mg.). That’s a lot of dope.

I’d been given these meds in the hospital, and they made me feel dopey, dizzy, nauseated and stuporous, so I stopped taking them after a couple days. 

But I wondered: how many patients  – relatively comfortable, as I was - just keep taking them, assuming they should, because their trusted doc sent them home with them. 

Some people, through no fault of their own, become addicted to them very quickly. Some are more wired for that response, too. No surprise that the U.S. now has a serious epidemic of addiction to prescription drugs - particularly to painkillers – in large part because of the unintended consequences of well-meaning practices like this.

The good news is, there’s now a lot of research on alternate ways to deal with pain. Mind-body practices like guided imagery, meditation, acupuncture, and general relaxation have become important interventions to study, because they do no harm and can sometimes reduce just enough pain.

Just last month, a pilot study was published in the American Journal of Medicine that examined how mindfulness meditation modulates pain. It showed that the practice made great use of the body’s natural endogenous opioid pathways, increasing its analgesic effect and growing more resilient with increased practice.

This is not exactly a surprise. For years, our veterans have been telling us that after even one session of guided imagery, their knees and backs and headaches are hurting less, and sometimes not at all – at least temporarily. But it’s nice to see this reported in a study, published in a prestigious journal, just the same.

Let’s look forward to the day when docs prescribe a lot fewer opioids, along with some meditation and guided imagery, and send their post-op patients home with some powerful, audio medicine in their self-care tool kits. (And to be fair, some already do.)

All best,

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1 Sharon H, Maron-Katz A, et al. Mindfulness Meditation Modulates Pain Through Endogenous Opioids. Am J Med. 2016 Jul;129(7):755-8. doi: 10.1016/j.amjmed.2016.03.002. Epub 2016 Apr 1.

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