Plastic Surgery and Opioid Addiction
Recently renowned actress Jamie Lee Curtis opened up about celebrating her 20 years of being sober. In the Variety “Recovery Issue” Curtis detailed the start of her painkiller addiction stemming from a plastic surgery procedure. After an offhand comment made by a cameraman on set, Curtis decided to go under the knife for a minor procedure and in turn got prescribed Vicodin by her doctor, even though she felt the pain was minimal and rather unnecessary. She now feels she is lucky to be alive.
Opioid addiction is a public health crisis that affects all areas of medicine including and especially cosmetic medicine. According to NCBI, “Surgeons routinely prescribe opioid pain medication postoperatively, and are responsible for 9.8 percent of the total opioid prescriptions in the United States.” Reuters Health reports, “Opioids account for more than 90 percent of the painkillers used after plastic surgery.”
Unfortunately, for many that receive plastic surgery, pain medication regularly accompanies the recovery process. Although many patients that go through plastic surgery are made aware of the risks involved with the procedure itself, the risk of opioid addiction during the recovery phase is often an afterthought.
Plastic surgery is on the rise globally, everything from nose jobs to full body reconstruction procedures, and most have extended recovery timelines. A portion of patients do experience post op complications and request pain medication refills, but others continue to refill their prescription long after their pain is absent.
Plastic surgeons often feel the dilemma of wanting to ease their patients of their discomfort without causing long term use, prolonged abuse and possible addiction. Some plastic surgeons do make efforts to identify those they feel may be at-risk for addiction and make sure to offer education and counseling, however with the increased number of patients, it becomes a challenge.
While most of the recovery after plastic surgery is physical, some patients find themselves coming to terms with a heavy emotional toll. While there are a portion of patients that are left feeling dissatisfied with their results and can become depressed, those that are generally satisfied with their results can still face depression.
While the pain and initial appearance can lead one to become unhappy other factors include difficulty performing everyday tasks and a lack of support from friends and family can lead to depression. Others have difficulty just getting used to the new version of themselves.
Some studies have found that the suicide risk is three times higher among women who have undergone breast augmentation than in the general population, which may be due to mental health concerns prior to surgery. Patients with a history of depression, anxiety, personality disorders, BPD and other mental health conditions generally worsen their symptoms after surgery.
Although each individual will have a different pain threshold, patients should be conscious of their pain levels and mindful of the number of pills they are taking. Listening to their body is important and speaking with your surgeon extensively about your options before surgery is helpful. Some surgeons offer long-acting local anesthetic that some patients feel is enough. Your post op recovery should be as thoroughly discussed in the initial consultation and discharge.