Changing how we treat pain - opioid free

An American woman who moved abroad and needed a hysterectomy recently wrote the German doctor told she should sip some herbal tea and, instead of opioids, try an over-the-counter ibuprofen for the pain. 

She was shocked but as she wrote about her experience in The New York Times, she realized the doctor was right.

We, in the United States, represent four percent of the world's population -- yet we use 95 percent of the world's opioids. So there's something about us Americans that we just like taking opioids; we like taking pills for that quick fix," says Dr. Roy Soto. He's an anesthesiologist with Beaumont Hospital who's trying to change the conversation when it comes to pain management. 
"We are not saying that people should have uncontrolled pain; we are not saying opioids are the root of all evil by any means," he says -- but we're learning now these powerful painkillers can quickly turn into a dangerous, even deadly, addiction. 

The opioid crisis ramped up in the '90s when doctors started freely prescribing opioids like Vicodin. Now patients expect to be comfortably numb, from teens getting wisdom teeth removed to adults going through minor or major procedures. 

"It's part of the culture now that, if people have an operative procedure, they expect to have zero pain and, when they do have pain, they expect to receive opioids to make that pain go all the way away," says Dr. Soto. "They want to be out of it. And that's really not realistic."

Dr. Soto is on the governor's opioid abuse commission, working to stop the opioid addiction epidemic. But he explains to do that, doctors and patients need to change expectations, meaning more honest communication between doctors and patients that could sound something like this:

"Ma'am, we're going to do your gall bladder operation. It's an invasive operation, even though it's a minor operation, and you're going to have three or four incisions that are going to hurt afterwards. The pain sometimes goes up to your shoulder for a couple of days, and there's really no way of making that pain go away. 

“I would recommend after your surgery, resting as much as possible. It will probably take you a week before you're really back on your feet ... and you'll probably be sore for two weeks afterwards," Dr. Soto says as an example.”

His example is a way of helping patients understand the pain expectation, and then treating the pain with alternatives to opioids is, of course, recommended. 

As far as the American with the herbal tea? She drank the tea, rested and felt some pain but it helped guide her healing. In the end, she wrote she was very happy to only have taken an over-the-counter ibuprofen.