What should you know about pain killers after surgery?

April 17, 2013

Recovering from major surgery is an active process that typically takes 6 weeks. Surgical pain is normal and expected, but the pain experience may be different for individuals. Since pain can interfere with your ability to participate in activities to prevent complications (coughing, deep breathing, walking), treating pain is critically important for a successful surgical recovery. Many patients are afraid to take prescription narcotics or “pain killers” because they do not want to become “addicted.” However, untreated pain can lead to the development of permanent pain pathways to the brain, which can delay your recovery and possibly even result in chronic pain.

Narcotic use varies among individuals and there is a big difference between drug dependence and addiction. Dependence is when the body has become accustomed to the medication. This can occur anywhere from a couple of days to a couple of weeks after you start taking pain killers regularly, like after surgery. Addiction, however, generally implies that the medication or substance is interfering with your life in some way. You can become dependent on pain killers during your surgical recovery, but with medical management of your withdrawal from these medications, you will avoid addiction. It is important to use your prescription pain killers as directed to avoid overuse. On the other hand, you do not want to avoid using pain killers when you need them to remain comfortable and active. Stopping your pain killers “cold turkey” can be dangerous and it may cause considerable discomfort. The surgical team will work with you to develop a plan to wean you off your pain killers gradually and safely, at a time when you are ready.

The universal goal is to taper as quickly as your physical, mental and emotional status allows. Since there is no single way to taper off pain killers, each situation should be managed on an individual basis. In general, a slow taper is better tolerated by the majority of patients. This usually involves gradually reducing the dosage of the pain medication over time. For example, you may reduce the dose by 10% every 3-7 days until you are taking the lowest available dose. After dose reductions, you then decrease the number of tablets you take per day until you are off pain medications completely. Other medications may be added to treat possible side effects of withdrawal and to keep you comfortable.

Even with a slow tapering of your pain killers, you may still experience some withdrawal symptoms. The common withdrawal symptoms include: anxiety, increased heart rate, high blood pressure, rapid breathing, sweating, nausea, vomiting, abdominal cramps, insomnia, muscle aches and restlessness. These symptoms can be mild to severe and can last up to 5 days after stopping your pain killers. The surgical team will want to stay in close communication with you to help you manage your medications and to monitor how you are feeling.

There are also several things that you can do during the weaning process to help minimize withdrawal symptoms. These include drinking lots of water, avoiding caffeine and alcohol, taking vitamins, eating a balanced diet with lots of fresh fruits and vegetables, and staying active. Six weeks after an operation, you should be able to increase your diet and activity, as tolerated, until you return to your usual activities. You will feel better once you have transitioned off of your pain killers and your surgical team will help you through that process.

Topics: Services, Surgery


great information. i appreciate it and recommended to the people after surgery. article also break some myths about pain killers.thanks for help
This is very helpful and educational.
Thanks for info. I was on dilaudin 4mgs per day and am now 6 weeks out from knee surgery. Very helpful and am off 5 days, though am very sensitive to any meds your description is on the mark. Thank you.
This information gives surgery patients much helpful information as they prepare for the need they will have for prescription pain medication following surgery. Communication with their medical team is critical to prevent a drug addiction from forming. The journey through drug addiction recovery is a long and hard one and it is best to prevent the need for it in the long run.
I'm five weeks post surgery - double knee replacement - I was 'shamed' into coming off medication because a couple of people stated they were drug free after three weeks. So I gave it a go - the pain is not unmanageable but I feel that the withdrawal from oxycodeine is not quite what I expected - hot flushes, breathless, 'all about' and generally not very well Grateful to read that it's all quite normal and ofcourse grateful for the relief the drugs gave initialy
Thank you for this helpful, realistic approach to post-surgery painkillers. I am grateful for both the good of these drugs and good ways to get off of them, gradually, over time, with professional advice as we go along. 3.5 wks post-knee surgery now and sometimes able to go several hours, but at sig. cost I guess.
I am 7 days post op after my 3rd intestinal surgery in 1 month. Was on Dilauted 4 mg every 2 hours in the hospital for 3 weeks and nearly lost my mind. I am cold turkey off pain meds on day 3 of withdrawal.symptoms are getting better. Looking forward to being clean and not having blurred vision. Surgical pain is a lot but it's worth dealing with to be off these nasty meds. Thanks for the information. It has been extremely helpful.
I was on Percocet and Oxycontin for several years. I'm off now for 3 months. I think I'm going to have to have a knee replacement and having had one already, I know that my lack of sensitivity to opioids made my immediate post op recovery very painful. How long after stopping opioids does one develop sensitivity to their pain killing potency again? I'm not having this done until I'm guaranteed I can have some pain relief.
Thank you very much for the information you have provide details in this article. I found it very helpful in understanding the long and uncomfortable process of getting Percocet out of my system completely. I had knee replacement surgery 10 weeks ago and about 3 weeks ago started to feel the effects of withdrawal you described. I started to experience them about 36 hrs after dropping my dosage in half and didn't realize what was happening to me. I'm from Northern California and was in Seattle on business when I suddenly started to experience nausea, shortness of breath, cold sweat, high blood pressure and fast/shallow breathing. Fortunately I had work colleagues close and was able to get to the Swedish Emergency Hospital in Mill Creek where they took excellent care of me. My Primary Care Physician now has me on a dosage reduction plan and I'll be off Percocet completely in about a month. I have learned through this experience that even though opioids can be very helpful in managing pain after surgery, they are not something to be treated lightly and can be VERY dangerous if misused.