PHILADELPHIA - Elizabeth Lopez took a familiar path to addiction. She was offered, and took, Oxycontin without any idea how addictive it can be.
From there she not only had to overcome her addiction, but also to find a way to manage the pain from surgery without the use of opioids.
Lopez, of Conshohocken, Pa., says her substance abuse took off her freshman year in college, after taking a seemingly harmless pill at a party.
"It kind of took away all my troubles and worries, and gave me a way to escape," she said.
But, she admits, she had no idea what she was in for.
"I didn't know that Oxycontin was extremely addictive," she said.
Lopez says she never dreamed how low addiction would take her, erasing a lot of "I will never..." pledges.
"Because a lot of your values and morals kind of go out the window, because you become solely focused on getting high," she told us.
She was not only hooked on painkillers, but for a time she took heroin as well. Finally, after graduating college, and several tries at treatment, she eventually overcame her addiction, and has been clean for over 4 years.
Managing the Pain: Elizabeth Lopez's story
Little did she know that another major challenge was coming her way. It began when she ruptured her Achilles tendon during a pickup basketball game.
'My first thought was, 'What am I going to do? I'm an opiate addict and I'm going to have to have surgery,'" Lopez said.
Opioids are often used in orthopedic treatments, especially after major surgery, such as joint replacements.
Lopez has been clean and sober for four years. So, she told her surgeon at the Rothman Institute bluntly: no narcotics.
"She looked at me and said, 'That's totally possible.' And I can't tell you how that changed my perspective," she said.
Lopez found out that the Rothman Institute - the area's largest orthopedic practice - now has a comprehensive program to scale back the use of opioids.
Dr. Asif Ilyas says Rothman uses a multi-prong strategy to keep patients' pain in check, while also reducing the use of opioids.
There's a detailed discussion of the risks and benefits in a brochure, a video discussing the opioid epidemic, and an explanation about to manage their pain after surgery.
"Recommendation number one is to try to use non-opioid medications," said Dr. Ilyas.
During surgery, non-opioid medications are emphasized, such as nerve blocks, intravenous Tylenol, and medications that prevent nerve pain.
Doctor Ilyas says studies show it works.
"Just formally educating patients on the risks and benefits of opioids and their safe use can decrease consumption by half to two-thirds," Ilyas said.
Lopez says her pain never got above five on a scale of one to 10. She's thankful for Rothman's cautious approach, and wishes more doctors followed it.
"I've had friends that had to have surgery because they had an injury, and that's not the message they received from their doctor," she said.
So what can you do to reduce your risk of dependency? Here are some suggestions from the Pennsylvania Orthopedic Society:
-Try non-opioids, like ibuprofen or Tylenol, first. You'll want to take these ahead of the pain.
-Add in alternatives such as using ice or elevation.
-If you do take opioids, take the minimum amount and for the shortest time.
-Never drink alcohol or take anxiety or sleep medications when taking opioids.
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