Adam’s Journal
We have lots of curious coworkers at the Oklahoma Medical Research Foundation, and here’s a query from one:
My husband recently had a fairly minor carpal tunnel surgery, and his doctor prescribed oxycodone for him. We’ve seen so many bad things about it that he was nervous to take it. However, when we asked, the doctor said that’s all she would prescribe (other than a similar narcotic) but that if he preferred, he could instead take over-the-counter medications like Tylenol or ibuprofen.
Luckily, the pain wasn’t too severe and he was okay without taking any of the oxycodone, although we did fill the prescription just in case. Is there a better alternative we could have asked for? If not, is it ever safe to take an opioid like oxycodone, or is it better to just stay away if possible?
Beth Benefield
Dr. James Prescribes
Controlling pain post-operatively has many upsides. In addition to making patients more comfortable, it can aid in a faster recovery, improve mobility, reduce complications like pneumonia and blood clots, and lead to better sleep.
For many surgical procedures, post-operative pain should only last a few days. Still, for major surgeries, over-the-counter pain medications may not be sufficient. That is why physicians prescribe opioids like oxycodone.
Oxycodone is a powerful pain medication. In addition to its well-known addictive properties, it can lead to sleeping difficulties, constipation, other gastrointestinal issues and confusion. Especially at higher doses, it can also lead to decreased breathing, which can be dangerous.
Certain people need to be particularly careful about taking narcotics: those with a personal or family history of drug or alcohol addiction, breathing problems, major liver or kidney damage, and those of advanced age.
If pain can be managed with over-the-counter drugs, ice, heat, or any combination of approaches that don’t involve prescription medications, that’s ideal. It’s important to know that for some procedures or patients, non-narcotic approaches like non-steroidal-anti-inflammatory drugs (such as ibuprofen or naproxen) won’t be safe because of concerns about bleeding.
In other cases, physicians can sometimes prescribe tramadol, a narcotic with somewhat less addictive properties, for a few days followed by over-the-counter pain medications like Tylenol and ibuprofen.
Of course, this question is best answered by a patient’s physician and surgeon. The severity of the pain, the risk of addiction, potential side effects, and other patient-specific issues need to be weighed and discussed to ensure the best post-operative experience and surgery outcome.
As a final note, it’s best not to fill a prescription you’re not planning to take. Unused narcotics can be tempting for a visitor with a substance abuse problem or a curious child. If you need to dispose of medications, Oklahoma’s Rx Take Back Program offers more than 200 take-back boxes around the state. Find out more at www.obndd.ok.gov.
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Dr. Judith James is executive vice president and chief medical officer of the Oklahoma Medical Research Foundation. Adam Cohen is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
