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Anesthesia

Revealing past drug abuse before surgery/anes

03/12/2008

Question:

10 years ago, after failed back surgery, I was on chroniclow-dose percocet (1 at bedtime) for several years...then, on my own, I increased the dose and got myself somewhat addicted (my fault not the docs)....anyway, sent myself to rehab and haven`t touched narcs for about 8 years. I have upcoming surgery (spinal fusion) I have been debating about telling my currect doc/anes provider about my former drug abuse (nobody knows about it). On one hand I want to be honest, but a nurse who works with the surgeon says that the recovery will require at least a small amount of narcs and that patient`s who mention past addiction get sent home with inadequate meds (NSAIDS or Tramadol)......Since my addiction episode, I had a hernia operation and was given 30 percocet and only took about 1/2 of them and felt no compulsion to take more. I learned my lession. I really am really afraid to have surgery then to be told that I can`t have the meds that are usually prescribed. I trust what this nurse says; should I say nothing? thanks.

Answer:

On the contrary, you should tell the anesthesia provider about your past history and it is their obligation to adequately treat your pain first. Your pain is going to be worse for the first few (3-5) days. Then, it will gradually decrease. Tell the providers everything, including your experience with hernia surgery. You will likely be discharged with a taper regimen of narcotic medications and if you feel you have a problem with the discharge medications you should seek specialty (addiction medicine) help.

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Response by:

Salim M Hayek, MD, PhD Salim M Hayek, MD, PhD
Associate Professor of Anesthesiology & Perioperative Medicine
School of Medicine
Case Western Reserve University