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  • BDD Moderators: Keif’ Richards

Drug habit before surgery ?

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RoxisLover

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Mar 31, 2011
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I didn't know what category this fell under so please move accordingly.

I have a drug habit that includes oxycodone or opana ( depending on which one I can find at the time ) an adderall. I'm having surgery next week and they called to ask all sorts of questions about what meds I'm on and I told them none because I dont want that out it the open. So my question is do I need to stop drug use prior to surgery and how long before if so ?

Thanks
 
i would not take any opiates before you go into surgery because usually the anesthesia is a strong benzo or ketamine which both suppress the CNS system and you could possibly OD in a sense if oyu are opiates aswell as the anesthesia.. are you physcially dependent on them??? if you are try taking a really low dose or try suboxone
 
You need to tell the surgeon/anesthesiologist. For a few reasons, including the safety of the anesthesia and post op pain control, not to mention so they are aware of, and can adjust for, any tolerance you have to ensure effective anesthesia and effective post op pain control.
 
laCster said:
i would not take any opiates before you go into surgery because usually the anesthesia is a strong benzo or ketamine which both suppress the CNS system and you could possibly OD in a sense if oyu are opiates aswell as the anesthesia.. are you physcially dependent on them??? if you are try taking a really low dose or try suboxone
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I'm not dependent on them. I have a fairly low tolerance at about 30mg oxycodone or 10mg opana to get a very strong buzz going. I would have no problem stopping them the day before. Will I be fine with the adderall though ?
 
rangrz said:
You need to tell the surgeon/anesthesiologist. For a few reasons, including the safety of the anesthesia and post op pain control, not to mention so they are aware of, and can adjust for, any tolerance you have to ensure effective anesthesia and effective post op pain control.
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Do you think this would have an effect since my tolerance isn't very high ? Check above.
I don't want to tell them and they have it on my chart so it screws me out of ever getting any in the future from a doc.
 
Not being an anesthesiologist, certainly not being YOUR anesthesiologist, and having no clue as to your history, what the procedure is, or what the anesthesia regiment and post op regiment is planned, I can not give you an answer that is anything close to a valid approximation. Tolerance to 30mg is still some level of tolerence tho, and it is a distinct possibly it could affect the anesthesia and/or your post op.

Similarly, so can the adderall. Aside from the obvious part about it making more difficult to ensure proper sedation/unawareness/amnesia, its effects on other, more subtle(but very important) functions of your body has quite a bit of overlap with a good number of commonly used substances in anesthesia. Even with only a modest familiarity with such subjects, it's a bit tl;dr to type it out.

Best advice me, or anyone here can give, is talk to the attending physicians and surgeons
 
You definitely need to tell them you've been using opiates. This isn't just a matter of looking good for your doctor, or having a clean record, there's potential for very dangerous interactions here.
 
nAON said:
You definitely need to tell them you've been using opiates. This isn't just a matter of looking good for your doctor, or having a clean record, there's potential for very dangerous interactions here.
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Even if I stopped like 2 days before so they were surely not effecting my CNS ? I have been put to sleep a few weeks ago for a colonoscopy and had no problems, but I don't know if the sedation is any different for a surgery that's why I asked. I am having my colon removed and it will only take around 2 hrs if that has any factors into it.

Thanks for the responses.
 
I have always been completely honest when getting surgery. I told my surgeron i had taken cocaine etc it's the only real way to get the correct anesthesia if you don't want to tell them then you need to stop 72 hours before your surgery to be certain there will be none left in your system in my opinion.

As per your above post then that was a stupid thing to do anesthesia has enough risks of death without taking opiates alongside it without medical direction.
 
definitely don't do the suboxone suggestion...even more interactions, if they attempt to use an opiate for whatever reason it won't work (would suck if it's for pain relief).

anesthesiologists hold your life in their hands and need accurate information.

if the doctors don't give adequate pain meds due to "abuse potential," it's a horrible trade off, but at least you seem to have access to them anyway.
 
RoxisLover said:
Even if I stopped like 2 days before so they were surely not effecting my CNS ? I have been put to sleep a few weeks ago for a colonoscopy and had no problems, but I don't know if the sedation is any different for a surgery that's why I asked. I am having my colon removed and it will only take around 2 hrs if that has any factors into it.

Thanks for the responses.
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General anesthesia is vastly different from procedural sedation. Do not play around with it. Anesthesiologists have more or less then same amount, length and difficulty in terms of residency and fellowship as neurosurgeons and cardiac/cardthor surgeons, with good reason, as it is one of the most complex, touchy and risky areas of medicine. Don't make their job of a) ensuring you wake up again and b) that when you do, you are not disabled or in blinding pain any harder than it is already. Tell them exactly what you are on, and what you have been on recently.

Just for the information sake, that is rather major operation. Open abdominal surgery for total resection of the large intestine a BIG deal. As I said, its radically different then some midazolam for a colonoscopy. Be honest to them.
 
qwe said:
definitely don't do the suboxone suggestion...even more interactions, if they attempt to use an opiate for whatever reason it won't work (would suck if it's for pain relief).

anesthesiologists hold your life in their hands and need accurate information.

if the doctors don't give adequate pain meds due to "abuse potential," it's a horrible trade off, but at least you seem to have access to them anyway.
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I'm not so much worried about what I will be prescribed or administered with after surgery for pain as I can handle that myself if it isn't up to par as you stated. My only concern is some sort of interaction when being put to sleep during surgery. If they normally use benzo or ketamine to put you asleep then I don't understand where my "slight" opiate tolerance has to do with anything. Which in turn makes me think if I quit a day or 2 before then there would be nothing in my system effecting my CNS so Im not following where any complications would come from ? I'm listening to you guys and take it into consideration, but if someone understands what I'm confused about and can explain to me why I am wrong please do.

Thanks
 
Because the benzo/barbiturate/propofol is usually only an induction agent, and/or part of balanced anesthesia. Most surgical anesthesia includes an opioid, like remifentanil or sufentanil or one of many others. Why? Because hypnotics like a benzo or thiopental do not have any analgesic effect as such, and while they do render you unaware of the surgery. The extremely noxious stimuli of being cut open and retracted etc, still produces a lot of action in the nerves. Which, if not somehow reduced/blocked by something that inhibits that, leads to hypergelsia/irritation of said nerves, and upon awaking provides you with a world of pain. Other options include a spinal and local anesthesia to prevent the effect, or ketamine. But ketamine is not commonly used in adults outside of emergency/trauma because of its emergence effects. In any event, you and me do not know what they are going to use, and you would not want any unexpected situations to arise because he or she does not know about it.
There are other possible interactions, not all of which have to directly with opioid tolerance per se, but due other effects and interactions caused by i.e. the metabolism and metabolites of the various drugs, induction and inhibition of enzymes, etc ad neasum.
 
rangrz said:
Because the benzo/barbiturate/propofol is usually only an induction agent, and/or part of balanced anesthesia. Most surgical anesthesia includes an opioid, like remifentanil or sufentanil or one of many others. Why? Because hypnotics like a benzo or thiopental do not have any analgesic effect as such, and while they do render you unaware of the surgery. The extremely noxious stimuli of being cut open and retracted etc, still produces a lot of action in the nerves. Which, if not somehow reduced/blocked by something that inhibits that, leads to hypergelsia/irritation of said nerves, and upon awaking provides you with a world of pain. Other options include a spinal and local anesthesia to prevent the effect, or ketamine. But ketamine is not commonly used in adults outside of emergency/trauma because of its emergence effects. In any event, you and me do not know what they are going to use, and you would not want any unexpected situations to arise because he or she does not know about it.
There are other possible interactions, not all of which have to directly with opioid tolerance per se, but due other effects and interactions caused by i.e. the metabolism and metabolites of the various drugs, induction and inhibition of enzymes, etc ad neasum.
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Thanks for your insight information. If anyone else has experience with this or think you have more knowledge that would be helpful please chime in. I understand telling them is the best option in this case, but I want to be 100% sure it is absolutely nessicary before I screw myself over and have all future doctors viewing me as an addict ( which in turn will lead me to never get pain meds or adderall legit which i planned on doing after all this is done ; the only reason i dont have a script is because im trying to get all my problems fixed before i move onto the smaller things in life. Mainly I am only wanting adderall an the opiates are just to take away the "bad effects" that adderall causes like circulation issues, help calm me down to sleep at night, etc... at the moment) when they look at my chart.
 
Looking for someone to tell you its ok doesnt make it so. I think rangrz is right. And not to listen is putting your life at risk. THAT is your own choice but we are trying to make that risk as low as possible. EVERY bout of anesthesia risks your life by itself.
 
madog11 said:
Looking for someone to tell you its ok doesnt make it so. I think rangrz is right. And not to listen is putting your life at risk. THAT is your own choice but we are trying to make that risk as low as possible. EVERY bout of anesthesia risks your life by itself.
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I'm not just looking for someone to tell me ok. I'm looking for the person who has the most knowledge about the situation and every little bit could help.

Would this scenario work ?
If I told them I took them a lot a few years ago and had a high tolerance so I thought I should tell them. Being realistic my tolerance isn't much higher than someone without. I can take a 10mg Percocet and still feel subtle effects. If the adderall doesn't really have an impact then that tolerance shouldn't matter and I will not have any effecting me at the time of surgery. I'm just failing to understand how such a small tolerance over a opiate naive person could have such an impact, but if no one else chimes in to resolve this then I will be letting them know based on the knowledge you guys have given me.

Thanks again
 
Years would bring your tolerance back down so that wouldn't work. As I've said in the end it's your choice. But I think rangerz post hits the nail on the head. You won't get better, clearer information than that.

Good luck.
 
I have been in this situation. Had my gallbladder removed and stayed a week due to complications.
I Was perfectly honest. They put me on methadone during my stay, and upped my morphine. Covered my pain and then some.Don't lie or anything.
 
Always be honest with your doctors. I was in clinic the other day talking to a patient, and he was on a beta-blocker for his heart condition. He tested positive for cocaine after explicitly telling me he never used. That's a life threatening interaction.

I know the situation is different, and if anything it's way more serious. I told my doctors before I went under that I had a fairly hefty tolerance to benzos, which I'm sure the physician took into account while he injected midazolam. Being honest is definitely better than being dead.

And DO NOT take suboxone/subutex, as someone suggested. The pain medication they give you during/after surgery won't work if you have bupe in your system...and that'd be a major bummer
 
Hi, you've received all of the (correct) information / advice you can get on this subject. Stop AND be honest. Anything else is taking a risk that we can NOT suggest.

This is getting far too close to doctor discussion, and has run its course.

Closed, PM me with any queries.
 
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