If your teenager needs surgery, you’re sure to have many questions and concerns for the physician. What does the procedure entail? What about complications? What should you expect the recovery period to be?
But one of the most important questions—one that could have lasting effects—might be overlooked: What medicine will be prescribed for pain following surgery?
While doctors have been prescribing fewer opioids to teens in recent years, 32 percent of teens who misuse opioids start with a prescription from their doctor. Given these risks, how can you protect your child from opioid misuse while still treating their pain? To answer this question, it’s important to consider why teens are prescribed opioids in the first place.
One study shows that surgery actually accounts for 25 percent of all teen opioid prescriptions, as it’s customary for opioids to be prescribed for two weeks or less following a surgery. But sometimes short-term use can stretch into the long-term.
A recent study of 90,000 teenagers with surgeries found that 1 in 20 were still taking their opioid pain medication up to six months after their surgery. These five common surgeries had high rates of long-term opioid use:
Bone fracture surgery. Growing teens are prone to bumps, bruises, breaks and fractures. The most common type of upper arm injury in kids is a fracture at the narrowest point of the upper arm bone, also known as a supracondylar fracture. These fractures sometimes require surgery.
Gallbladder removal surgery. The gallbladder is a small pear-shaped organ in the abdomen that stores bile produced by the liver. When the gallbladder becomes inflamed, a surgical procedure called cholecystectomy is required to remove the organ.
Hernia surgery. A hernia occurs when an organ or internal tissue breaks through a hole in the muscles. They typically occur in the abdominal region and surgery is often required to return the tissue to its original place and strengthen the surrounding muscles tissue.
Appendectomy. The appendix is a thin tube that extends off of the intestinal tract into the lower right abdomen. Although the function of the appendix remains unclear to experts, the appendix can become inflamed and infected. When this happens, surgery is required to remove it.
Tonsillectomy. Surgery to remove the tonsils is among the most common procedures performed on kids. The tonsils are two small glands located in the back of the through that can help fight infection. However, when the tonsils become infected, sometimes they have to be removed.
As a parent, it’s important to discuss pain management with your child’s prescribing physician—especially when undergoing one of the five surgeries mentioned above. Good questions to ask include:
- When should my child take this medication?
- How much?
- For how long?
- What side effects should I watch for and what should I do if I see them?
- What should I do with the leftover pills?
In addition to talking with their doctors, you can talk directly with your teen. Settle on a plan together on when they should stop taking opioids within an appropriate timeframe post-surgery.
Even though opioids are not necessary for most dental procedures, teens are often prescribed them. The American Academy of Pediatric Dentistry’s policy on pain management, however, states that non-opioid medications such as ibuprofen or naproxen are the preferred pain treatment.
As a parent, you can ask the dentist to choose a non-opioid analgesic for your teen. If the dentist pushes for an opioid, ask for an explanation—and consider filling the prescription only if the pain becomes too severe. An opioid should only be prescribed for about three days of treatment following a dental procedure.
Severe Medical Conditions
Opioids are effective painkillers that can bring comfort to teenagers with debilitating pain when other pain management options don’t work. Serious medical conditions such as cancer, severe trauma and sickle cell anemia often warrant treatment with opioids. Children with these painful conditions may even take opioids for long periods of time.
It is important for parents, teens and doctors to agree upon goals for pain control throughout the child’s illness. Parents should also ask their doctors about side effects, safe storage of opioids and what to do in the unlikely event of an overdose. All of these are important to the safety of your child and family members.
Keep the Lines of Communication Open
Even with their risks, opioids are an important part of many treatment courses. To manage those risks, doctors, parents and their teens must have honest and open discussions, given that too few healthcare professionals initiate this important conversation. Parents have the power to take the lead and start talking. Don’t be afraid to ask questions and even challenge the prescriber. Your child’s life might depend on it.
DR. LAURA E. HAPPE, PHARMD, is a pharmacist, researcher and educator who uses data to help people make better decisions. She is also author of the new book, If you Give an Ox an Oxy. As an executive leader in the pharmacy and insurance industries, she has developed new businesses and strategies, including the opioid epidemic response at a Fortune 50 healthcare company.
Dr. Happe is chief editor of the peer-reviewed Journal of Managed Care and Specialty Pharmacy and a professor at the University of Florida and Wingate University. She lives with her husband in Charlotte, NC, where they teach their kids that happiness is a choice.