I’m reading Anthony Kiedis’s autobiography, Scar Tissue, and he talks mostly about his struggle with addiction. At one point, he managed to get clean in 1988, only to relapsed in 1994, after an operation to have his wisdom tooth removed. They were originally only going to use novocain, but the tooth was impacted and had to be cut out, so he was put on a valium drip.
In cases like that, are there any special procedures?
If you let them know about your addiction problems, they will more than likely use a non narcotic pain reliever like Ultram or something.
For significant acute pain, they use opiates.
I’ve had surgical procedures done on me during my recovery from opiate addiction. The opiate meds they gave me were necessary, and frankly didn’t give me much of a buzz, they just reduced my very real, very acute pain.
I made sure I wasn’t in control of the med, and stopped it as soon as possible, and kept in touch with my recovering buddies.
Significant acute pain and malignant pain merit treatment with strong drugs, even the strongest opiates if that is what it takes, regardless of addiction history.
For chronic pain, not so much. Opiates don’t tend to work well for most forms of chronic pain anyway.
Speaking as a doctor for addicts and chronic pain patients, and a recovering one myself, with chronic pain issues myself.
Oh, and I hate tramadol (Ultram). It’s caused a lot of recovering addicts to relapse, after they’re told it’s not mood-altering. 
Oh, and anesthesia is usually not an issue. Most folks don’t get addicted to or abuse anesthetics (save nitrous oxide). It’s the opiate analgesics.
It is a real issue. Some doctors just do their robot script thing. Others listen and try to work around it with another solution. Addiction can be strange though. My problem, like many people’s was alcohol. That was hard to fight but I have a prescription for a benzodiazepine very similar to alcohol in effect but I almost never take it. Somehow, the addiction didn’t transfer over from one delivery mechanism to another. Both my wife and I also have bottles of Oxycontin mainly unused on the medicine cabinet shelves. People rob stores or even kill people for those things. It was just like strong aspirin to me.
The key point is that no one truly understands addiction. A medical misjudgement could trigger a relapse in one person and not another. It isn’t a simple thing to figure out for anyone including the doctors.
Tell me about it. I went to the hospital one time with tooth pain. I know they can’t really do anything there about it, but I needed some kind of painkiller. I told them my history and they gave my Ultram and told me that it would be the best thing for me since I was a recovering addict. Instead, that gave me a little bit of a buzz since I had been clean for 4 years prior to that. But, ever since I got injured, I now HAVE to take them for chronic pain.
But I DO know for a fact that some doctors do prescribe non narcotic pain killers to recovering addicts quite often.
Oh, I agree. I do too.
I only haul out the narcs for more moderate to severe significant acute pain, like a badly sprained ankle, or post-op pain control, or similar. Not for a fibromyalgia flare-up, or chronic daily headache exacerbation, or “my back hurts again, and I just know I won’t sleep well if I don’t get some oxys”.
Ha, I bet you get the old “my back hurts” thing alot, don’t ya? heh. Also, out of curiousity, do you hate Ultram BECAUSE it might invoke a relapse or for other reasons?
Because I straight up hate it because it sucks and doesn’t do a damned thing for pain. Like most painkillers, as you’ve stated earlier.
I had to argue with an oral surgeon about pre- and post-op drugs when I had my wisdom teeth pulled. He insisted that I HAD to have valium before the anesthetic! No, thanks, I fucking don’t. :rolleyes:
I was given something for pain during labor with my oldest son (don’t remember what but damn did it work!), but I’ve never had to take narcotic pain medication any other time. 800 mg Motrin tends to crush most pain, and I have been known to take 1200 mg in a pinch (I get migraines periodically). I would try a lot of other options before I’d take something narcotic. I’ve just seen too many women drag their relapsed asses back into detox after a binge that started with a prescription med…
Oh, and how funny that I have tons of tramadol in my house! My dog takes it for pain (hips, knees)- he currently weighs about 125 lbs and takes 250-300 mg twice per day.
Quite a habit he’s got… :eek:
IME, most doctors are pretty understanding about pain management in the addict and will generally keep the patient’s wishes in mind. However, I’ve encountered two extremes. The first is “shut up and take it” and the second is “There is no way I’m giving you x drug. Here’s a non-narcotic substitute, and if that doesn’t work, we’ll keep trying non-narcotics in the hopes that we’ll find one that works. Meanwhile, just suck it up.” I ended up seeing new doctors; the former wouldn’t listen to me and the latter pretty much denied me the right to effective pain management.
So the short answer is “they do what everyone else does, they just have to be more vigilant about it.”
Robin
It’s medicine and I take it as needed, not to get high. If you have to have it, you have to have it. I even admit to enjoying the buzz I had coming to after an endoscopy. My wife drove me home, I went to bed nodded off and woke up bright eyed an hour later and picked up my car. I didn’t run out and get high the next day.
I had a collapsed lung in early sobriety and was hospitalized with a tube inserted in my chest. I was on demerol the entire time. I left with prescription for more, that I destroyed.
Having to use a pain medication for a chronic condition would be a difficult thing to deal with though, I have no doubt about that.
Remember that moron James Frey and his wannabe tough guy story about having oral surgery with no anesthetic because he was such a big, bad addict that it would cause a relapse? I didn’t read any of his idiocy till after the fact, but how could anyone have taken seriously for five seconds his premise of fiending for novacain?
As for post-op care – I’ve had oral surgery a few times. After the novacain wore off, I think I took one Vicodin once, otherwise, ibuprofen or naproxen did the trick.
There’s also some research showing that usage of opiates for actual pain produces different physiological reactions from when they’re used for getting high. That would help addicts who used the pain meds only briefly, for actual pain, keep from getting re-addicted.
I remember reading about it quite some time ago, but I’m not having any luck Googling for more recent info.
I got a definite buzz from a big novacain injection, right after I got sober. It was very odd. YMMV, of course.
That was where I stopped believing him. He supposedly had that oral surgery done in the course of rehab. I thought it was absurd that a recovery facility would have no provision whatsoever for administering anesthetic in a controlled fashion to an addict.
I got two fillings without novacain once- does that make me bad ass? 
I broke my collar bone 3 days ago. I’v been taking oxycodone or hydrocodone steadily since. I’ve been sober 21 years and intend to stay that way but this is wierd. The need for pain relief should decrease some every day but it hurts a lot so far.
I think I jinxed myself.
My husband broke his foot and im scared of the narcotics being prescribed. But what else is there that would work for him.
Other than being heavily sedated, not much for either you two.
A lot of relapses occur when the pain management schedule is not followed. Actually, not just for relapsed for for people in general. It used to be normal for someone to get a script and it was “take as needed” for post-surgical events. They then changed that to a specific regime. That way they are not “self-medicating” themselves as that’s how the addiction can start.
So, for the two of you, talking to the doctor and being on their specific regime would be the best chance. Broken bones really hurt. I’ve had a broken collar bone, bone surgery (twice). Collar bone was horrible, just horrible. The grinding sensation was over the top.