We recently had a patient who had been off of opiates and in recovery for around 12 months. He was receiving regular naltrexone treatment and feeling very good. Unfortunately, he hurt his back and needed surgery with a lumbar laminectomy - a very painful procedure. He was terrified that if he was exposed opiates, he would relapse, so he requested that he continue on his naltrexone treatment and go through the surgery without any opioid pain medicines at all.
He did beautifully.
Of course it was painful, but he found that the pain was actually quite tolerable once he set his mind to getting through it. The truth is that we humans have been dealing with broken bones and other painful conditions for over 200,000 years without opiates. We are certainly capable of handling and tolerating pain. While I'm not recommending this for all patients, it is certainly possible to do it. Most of the time, we recommend that if opiates are needed, our patients use the smallest doses of opiates for the smallest amount of time possible. We also recommend that they have someone else dispensing the medicines so that they do not have unlimited access. When people follow this approach they almost always do very well.
