By Dr. Maria Simbra

PITTSBURGH (KDKA) — For some people, prescription painkillers are a gateway to drug abuse.

Because of that, many hospitals have changed the way they treat patients for pain after surgery. Health editor Dr. Maria Simbra has more on the steps doctors are taking to combat America’s drug problem.

David McCabe, of Cranberry Township, was noticing more and more problems with his left hip.

“I’d have to get my good leg in[to his truck], and then I’d literally have to grab my pant leg to bring [my other leg] up and into the truck,” he said.

Another challenge, his motorcycle.

“The hard part was actually getting my leg up and on that peg again,” he said.

It was time for a hip replacement. But a big operation like that, and the pain afterwards, is no walk in the park. And the pain medicines can be a bumpy ride.

“I really couldn’t focus in on things, and I really wasn’t myself,” McCabe said.

For some people, this brief exposure to narcotic pain medicine is what leads to addiction problems.

“Post-operative opioid addiction is very rare,” Dr. Michael Seel with West Penn Hospital Orthopedics said. “We make a strong effort to wean the patients from any narcotics that they’re taking within four to six weeks of surgery. But it can still happen despite our best efforts.”

For that reason, over the last decade, doctors have changed the way they approach surgical pain, so that a minimal amount of narcotic relief is needed post-operatively, if at all.

This includes: pain medication even before the operation; spinal anesthesia that gradually wears off, as opposed to the sudden cut off of general anesthesia; nerve blocks at the site of surgery, and anesthetic injected into the incision site.

The new techniques don’t completely eliminate the need for narcotics, but they reduce it dramatically.

“It isn’t that we’re withholding pain management techniques, but it’s we’re substituting these other modalities for the narcotics,” Seel said. “That’s made a big difference in our patient satisfaction, less pain after surgery, and a faster functional recovery.”

For David, it was two weeks of prescription medicine after his surgery, then he switched to over-the-counter without any problems.

Even though it’s a small percentage of all people who get hooked from post-op opioids, Dr. Seel hopes this new approach reduces that number further.

“I think for sure, by minimizing the use of post-operative narcotics, even though it’s a small percentage, there is still a percentage of patients who are introduced to the medicines and have a difficult time getting away from them,” he said. “So I think that will reduce it to a certain extent.”

David is grateful for the temporary tool to get him through a quick recovery.

“Very soon after the operation, the truck was literally no problem at all,” he said. “But the motorcycle took a little bit longer to get there. I take little rides all the time now.”

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Dr. Maria Simbra