Postoperative Opioid Medication FAQ

In the United States, thousands of people die every year due to drug overdose. Sadly, many of these deaths involve a prescription opioid. Beyond the deaths and overdoses that opioids may lead to, these medications are often used improperly. In 2018, nearly ten million people misused these potentially dangerous medications.

While opioids have been in the news about their dangers, they are still an important kind of medication that may be recommended or prescribed to you. This is especially true if you are considering having surgery including a cesarean section, hysterectomy, surgery for fibroids, prolapse repair, or procedures to prevent urinary leakage.

What are prescription opioid medications?

Opioids are a type of medication that are used to reduce very strong pain. Prescription opioid medications include:

  • oxycodone
  • tramadol
  • morphine
  • fentanyl

These can be given to you by mouth (pills or tablets), through injections, or even through patches.

Why would my doctor give me these medications? 

After most large surgeries and also after some smaller surgeries, doctors often prescribe these medications to control strong pain. Patients are usually prescribed a certain number of tablets with instructions to take one or two as needed for a short amount of time after surgery.

What are the side effects of these opioid medications?

While these medications may help with very strong pain, they do have some risks, such as:

  • Constipation, nausea, vomiting
  • Drowsiness, mental fog, confusion
  • Slowed breathing
  • Addiction
  • Overdose (may result in needing to go to the hospital or even death)

To minimize the side effects of these medications, it is important to take the least amount as possible to have tolerable pain. The goal of the medication is not to get rid of all discomfort.

Constipation may be avoided or helped by making sure you are drinking enough fluids and possibly taking stool softeners if your doctor approves.

Although the risk of serious side effects like addiction, overdose, and death are rare, it is important to follow all of your doctor’s instructions about these medications. You should avoid medications or substances that make you sleepy or drowsy while taking opioids. This includes alcohol and some medications used for sleep or anxiety. Benzodiazepines like “Valium” and “Xanax” are two examples of medications that should be avoided.

Do I have to take these medications if I do not have severe pain after surgery?

Opioids should be taken only for strong or severe pain. For less bothersome discomfort, ice packs and heat may be helpful. In addition, over-the-counter pain medications (meaning those medications that do not need a doctor’s prescription to purchase) may be enough to treat the pain and should be used first. Even if they are not strong enough to treat your pain, these over-the-counter medications may allow you to take less of the opioids. Over-the-counter medications that may be helpful include acetaminophen (“Tylenol”), ibuprofen (for example, “Motrin” and “Advil”) or naproxen (for example, “Aleve” and “Naprosyn”). Before taking any of these, make sure you are allowed to take these types of medicines.

You should talk to your doctor before and after surgery about the plan for an opioid prescription. Together, you can decide if a prescription is necessary and if so, how many tablets would be right for you.

What else do I need to know about these medications?

While the risks to you of opioids are discussed above, there is another risk involving people around you, including friends and family. Unfortunately, sometimes these medications are stolen from the person originally prescribed the medication. The pills could then be used for recreational drug abuse or sold illegally. Because of this, if you are prescribed opioid medications by your doctor, it is important to keep these medications safe. To do so, avoid telling people not involved in your care that you have these medications. Another good idea is to keep them in a safe location, potentially even a locked box or drawer.

How can I safely dispose of extra opioid medication?

 You may find that you are prescribed more opioid medication than you actually need. Make sure to avoid keeping these in your medicine cabinet for future use. If you keep them around, they may serve as a temptation to yourself or others. Instead, you should dispose of the medication in a safe way.

Once you are finished using your opioid medication prescription, one of these three options should be used to discard the remaining medication. The options are listed in order of recommendation.

  • Drop-Off!
    • Check with your local pharmacy or hospital to see if they have a medication drop off bin for unused medication
    • Similarly, some police stations offer “Drug Take Back” days or drop off locations for medications like opioids
  • Flush! (if drop-off is not an option…)
    • Check to see if it is safe to flush the medication
    • Examples of medications that are safe to flush: oxycodone, morphine, hydrocodone
  • Trash! (If drop-off and flushing are not options…)
    • Use the following tips for safe disposal of extra medication in your garbage
      • Mix the medications (without crushing tablets or capsules) with an unpleasant material like coffee grounds, cat litter, or dirt
      • Seal the medications in a plastic bag
      • Throw away the bag in your home garbage
      • Make sure you remove all labels from the empty medicine packaging or bottles before recycling/disposal

Take Home Points

  • Opioid prescriptions may be necessary after surgery, but these medications do have some risks including addiction and overdose.
  • Patients should talk to their doctor before and after surgery to discuss if opioids will be prescribed and for how long.
  • Opioids should only be used for very strong pain. Other techniques for pain control should be used first or for mild pain. These include ice, heat, and non-opioid pain medications like ibuprofen or acetaminophen.
  • Opioids should be stored safely and discarded appropriately after they are prescribed.



Author Information

Emily RW Davidson, MD completed her undergraduate degree in Biology at Indiana University in Bloomington and her medical degree at the University of Chicago Pritzker School of Medicine. She completed her Obstetrics and Gynecology residency at the University of North Carolina at Chapel Hill and her fellowship in Female Pelvic Medicine and Reconstructive Surgery at the Cleveland Clinic in Cleveland, Ohio. She is now an assistant professor at the Medical College of Wisconsin in the Department of Obstetrics & Gynecology, Division of Urogynecology.

Disclosure: Dr. Davidson received a grant during her fellowship to study postoperative opioid prescribing. The grant was awarded by the AAGL for research in minimally invasive gynecology.

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