I’ve been given opioids after surgery to take at home. What do I need to know?
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Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.
These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.
However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.
Which types of opioids are most common?
The most commonly prescribed opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).
In fact, about half of new oxycodone prescriptions in Australia occur after a recent hospital visit.
Most commonly, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.
Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.
Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.
Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.
Controlling your pain after surgery is important. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.
Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.
But there are also risks
As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.
Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.
But up to one in ten Australians still take them up to four months after surgery. One study found people didn’t know how to safely stop taking opioids.
Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.
Dependency and side effects are also more common with slow-release opioids than immediate-release opioids. This is because people are usually on slow-release opioids for longer.
Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed more than twice the amount they needed.
This results in unused opioids at home, which can be dangerous to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.
How to mimimise the risks
Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).
These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.
Other techniques to manage pain include physiotherapy, exercise, heat packs or ice packs. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.
However, if you do need opioids, there are some ways to make sure you use them safely and effectively:
- ask for immediate-release rather than slow-release opioids to lower your risk of side effects
- do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing
- as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen
- before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.
If you’re concerned about side effects
If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:
- constipation – your pharmacist will be able to give you lifestyle advice and recommend laxatives
- drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor
- weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.
If you’re having trouble stopping opioids
Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.
You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.
How about leftover opioids?
After you have finished using opioids, take any leftovers to your local pharmacy to dispose of them safely, free of charge.
Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.
For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has free online information about managing pain and opioid medicines.
Katelyn Jauregui, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, University of Sydney; Asad Patanwala, Professor, Sydney School of Pharmacy, University of Sydney; Jonathan Penm, Senior lecturer, School of Pharmacy, University of Sydney, and Shania Liu, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, University of Alberta
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Darwin’s Bed Rest: Worthwhile Idea?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I recall that Charles Darwin (of Evolution fame) used to spend a day a month in bed in order to maintain his physical and psychological equilibrium. Do you see merit in the idea?❞
Well, it certainly sounds wonderful! Granted, it may depend on what you do in bed :p
Descartes did a lot of his work from bed (and also a surprising amount of it while hiding in an oven, but that’s another story), which was probably not so good for the health.
As for Darwin, his health was terrible in quite a lot of ways, so he may not be a great model.
However! Certainly taking a break is well-established as an important and healthful practice:
How To Rest More Efficiently (Yes, Really)
❝I don’t like to admit it but I am getting old. Recently, I had my first “fall” (ominous word!) I was walking across some wet decking and, before I knew what had happened, my feet were shooting forwards, and I crashed to the ground. Luckily I wasn’t seriously damaged. But I was wondering whether you can give us some advice about how best to fall. Maybe there are some good videos on the subject? I would like to be able to practice falling so that it doesn’t come as such a shock when it happens!❞
This writer has totally done the same! You might like our recent main feature on the topic:
…if you’ll pardon the pun
Enjoy!
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Hazelnuts vs Chestnuts – Which is Healthier?
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Our Verdict
When comparing hazelnuts to chestnuts, we picked the hazelnuts.
Why?
This one’s not close.
In terms of macros, we have some big difference to start with, since chestnuts contain a lot more water and carbs whereas hazelnuts contain a lot more protein, fats, and fiber. The fats, as with most nuts, are healthy; in this case mostly being monounsaturated fat.
Because of the carbs and fiber being so polarized (i.e., chestnuts have most of the carbs and hazelnuts have most of the fiber), there’s a big difference in glycemic index; hazelnuts have a GI of 15 while chestnuts have a GI of 52.
In the category of vitamins, hazelnuts contain more of vitamins A, B1, B2, B3, B5, B6, and B9, while chestnuts contain more vitamin C.
When it comes to minerals, the story is similar: hazelnuts contain a lot more calcium, copper, iron, magnesium, manganese, phosphorus, and zinc, while chestnuts contain a tiny bit more potassium.
All in all, enjoy either or both, but nutritionally speaking, hazelnuts are a lot better in almost every way.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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Science-backed ways to take care of your mental health this winter
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The colder, darker months can take a toll on well-being. Two out of five U.S. adults say their mental health worsens in the winter. Plus, about five percent of U.S. adults experience seasonal affective disorder (SAD), a type of depression induced by seasonal changes that typically begins when the weather gets colder and there’s less daylight.
Fortunately, there are science-backed lifestyle changes that can make this time of year more tolerable. Here’s how to take care of your mental health this winter.
Exercise regularly
When you exercise, your body releases endorphins, or “feel-good” chemicals that can improve your mood. A 2024 review of studies found that exercise—particularly walking, jogging, yoga, and strength training—can reduce symptoms of depression.
Before starting a new exercise routine, talk to your health care provider about the types of exercise that may work best for you.
Get outside
While getting outside during the colder months may feel challenging, time outdoors—especially in nature—has been shown to decrease stress, depression, and anxiety. Plus, sunlight helps your body make vitamin D, which may improve your energy and mood.
You can reap the benefits of nature no matter where you live.
“Cities can be very energetic and exciting but also can contribute to both conscious and unconscious stress from the sensory overload and challenges of maneuvering in those spaces,” said Jodie M. Smith, a Mayo Clinic nurse practitioner, in a 2024 Mayo Clinic article. “If you live in an urban environment, exploring to find even a small natural reprieve can be extremely beneficial.”
Prioritize sleep
Inadequate sleep has been linked to depression and anxiety. Taking steps to improve the quality and duration of your sleep can help you become more resilient against stressors.
You can improve your sleep by going to bed and waking up at the same time every day; avoiding caffeine, alcohol, and large meals before bed; keeping your bedroom cool and dark; and limiting exposure to distressing media in the evening.
Practice gratitude
Research suggests that people who practice gratitude are less likely to experience depression. It can also help you make lifestyle changes that improve your well-being overall.
“Practicing gratitude may also make someone a bit more motivated to take care of their health,” said Tyler VanderWeele, co-director of the Initiative on Health, Spirituality, and Religion at the Harvard T.H. Chan School of Public Health, in a 2024 Harvard Health Publishing article. “Maybe they’re more likely to show up for medical appointments or exercise. It may also help with relationships and social support, which we know contribute to health.”
Add more gratitude to your life by sharing what you’re grateful for with others or keeping a gratitude journal.
Spend quality time with loved ones
“Social isolation and loneliness have a serious impact on physical and mental health, quality of life, and longevity,” according to the World Health Organization, with effects comparable to other risk factors like smoking.
Research shows that people who have close confidants are more satisfied with their lives and less likely to experience depression. Even after holiday gatherings have ended, schedule time with friends and family to stay positive and feel supported.
Limit cell phone use
Social media use and “doomscrolling” inflammatory news headlines are both associated with anxiety and depression across age groups, especially in teens.
“Excessive social media use is associated with behaviors, such as poor sleep, increased social comparisons, impact on learning, and exposure to cyberbullying and negative content, that could contribute to the worsening of depressive symptoms,” Dr. Carol Vidal, an assistant professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine, said in a Hopkins Medicine article.
Minimize the time you and your family members spend on your phones by pausing notifications, keeping your phone out of reach when you’re preparing for sleep, using a “grayscale” setting to make scrolling less enticing, and finding phone-free hobbies to enjoy.
Light therapy
Light therapy is one treatment for people who have been diagnosed with SAD. It involves sitting in front of a bright light box for 30 to 45 minutes per day to increase light exposure.
This treatment may not be right for people who take certain medications or have eye diseases. Talk to your health care provider about whether light therapy is right for you and what type of light box you should use.
Seek professional support
If your mental health over the winter interferes with your daily functioning, seek help from a therapist, support group, or mental health hotline. Find resources here.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Kidney Beans vs Pinto Beans – Which is Healthier?
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Our Verdict
When comparing kidney beans to pinto beans, we picked the pinto.
Why?
Looking at the macros first, pinto beans have slightly more protein and carbs, and a lot more fiber, making them the all-round “more food per food” choice.
In the vitamins category, kidney beans have more of vitamins B3, C, and K, while pinto beans have more of vitamins B1, B2, B6, B9, E, and choline; another win for pinto beans. In kidney beans’ defense though, with the exception of vitamin E (31x more in pinto beans) the margins of difference are small for the rest of these vitamins, making kidney beans a close runner-up. Still, at least a nominal win for pinto beans here, by the numbers.
When it comes to minerals, kidney beans are not higher in any minerals, while pinto beans have more calcium, copper, magnesium, manganese, phosphorus, potassium, and selenium. In kidney beans’ defense, though, with the exception of selenium (5–6x more in pinto beans) the margins of difference are small for the rest of these minerals, making kidney beans a fine choice here too. Once again though, a winner is declarable here by the numbers, and it’s pinto beans.
Adding up the three wins makes for one big win for pinto beans. Still, enjoy either or both, because kidney beans are great too, and so is diversity!
Want to learn more?
You might like to read:
What’s Your Plant Diversity Score?
Take care!
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Stretching to Stay Young – by Jessica Matthews
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A lot of stretching gurus (especially the Instagrammable kind) offer advices like “if you can’t do the splits balanced between two chairs to start with, that’s fine… just practise by doing the splits against a wall first!”
Jessica Matthews, meanwhile, takes a more grounded approach. A lot of this is less like yoga and more like physiotherapy—it’s uncomplicated and functional. There’s nothing flashy here… just the promise of being able to thrive in your body; supple and comfortable, doing the activities that matter to you.
On which note: the book gives advices about stretches for before and after common activities, for example:
- a bedtime routine set
- a pre-gardening set
- a post-phonecall set
- a level-up-your golf set
- a get ready for dancing set
…and many more. Whether “your thing” is cross-country skiing or knitting, she’s got you covered.
The book covers the whole body from head to toe. Whether you want to be sure to stretch everything, or just work on a particular part of your body that needs special attention, it’s there… with beautifully clear illustrations (the front cover illustration is indicative of the style—note how the muscle being stretched is highlighted in orange, too) and simple, easy-to-understand instructions.
All in all, we’re none of us getting any younger, but we sure can take some of our youth into whatever years come next. This is the stuff that life is made of!
Get your copy of “Stretching To Stay Young” from Amazon today!
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Latest Alzheimer’s Prevention Research Updates
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Questions and Answers at 10almonds
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
I am now in the “aging” population. A great concern for me is Alzheimers. My father had it and I am so worried. What is the latest research on prevention?
One good thing to note is that while Alzheimer’s has a genetic component, it doesn’t appear to be hereditary per se. Still, good to be on top of these things, and it’s never too early to start with preventive measures!
You might like a main feature we did on this recently:
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