House Calls

WIN 2019

House Calls Magazine is a quarterly publication that focuses on health and wellness. It includes a wide assortment of articles with topics on the latest health and wellness information, nutrition, safety, lifestyles, and more.

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h o u s e c a l l s { winter 2019 } 27 In 2015, 63 percent of drug overdoses involved opioids. -American Society of Addiction P H O T O G R A P H ( T H I S P A G E , Y O G I ) B Y L E I G H W E B B E R majority of heroin users started out by abusing prescription opioids. While opioid addiction in the U.S. grew in the early 2000s, heroin production in places like Mexico and Colombia ramped up, flooding the U.S. market with an inexpensive, abundant, and stronger alternative to prescription drugs. By 2016, five times more people were dying of opioid-related overdoses than had in 1999, and it remains unclear today whether the crisis of opioid-related deaths has reached its peak. A NEW WAY OF THINKING To help change the trajectory of the opioid epidemic, doctors across the country have changed how pain is treated. "We do a number of different things now," Dr. Mitchell says of managing pain among bariatric surgery patients. The first step, he says, is educating people, setting expectations that after the procedure they won't be sent home with a lot of pain medication. "We're going to take care of your pain, we're just going to use different agents to do so," he says. The second step is preventing pain before it starts. That means an around-the-clock treatment of pain— before, during, and after a procedure—using non-narcotic pain relievers like Tylenol. Those undergoing orthopedic surgery can expect the stop- pain-before-it-starts approach, as well. For operations that can be particularly painful, such as a knee replacement, localized anesthetics are used to put the offending nerves to sleep long before the procedure begins, reducing the need for stronger pain relief later on. Other pre-operative drugs used might include non-addictive prescription nonsteroidal anti-inflammatory drugs (NSAIDS) like Celebrex and Toradol, or more familiar NSAIDS, such as ibuprofen (as in Motrin and Advil) or aspirin. Doctors may also use ketamine, which is not an opioid but has similar pain-relieving properties. Originally invented as an anesthetic, ketamine activates a different pathway than opioids, and, when used in small enough doses, does not cause confusion or sedation. After surgery, patients are prescribed tried-and-true solutions that don't require drugs at all: things like icing and elevating, focusing on good sleep habits, physical therapy, counseling, and even music therapy or aromatherapy (see sidebar on page 26). "Our

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