When you’re preparing for surgery, managing pain is an important part of your recovery plan. Opioids are one class of pain-relieving medicines that may be offered to you, especially for moderate to severe pain.

When taken as directed by a doctor and for a short period, prescription opioids can be a safe and effective way to manage pain — but they also carry a risk of misuse.

Opioids in the Surgical Journey: When, Why, and How?

There’s no one size fits all approach to pain management. Depending on your injury severity and circumstances, an individualized strategy to manage your recovery will be developed by your clinical team.  Here are a few things to expect:

Before Surgery

Your surgical team may discuss pain management as part of your surgery planning, which could include use of opioids.

They may decide to minimise opioid use where possible, using other pain relief strategies (e.g. non-opioid analgesics, local anaesthetics, nerve blocks).

Being open with your doctor about pain tolerance / threshold and any history of opioid use, previous side effects e.g.: nausea/vomiting substance use, or concerns can help them tailor your pain plan.

It’s good practice to bring your medication history and details of your previous surgical experiences to your surgical appointments, as this information can help your clinical team provide tailored advice.

Immediately After Surgery

Straight after surgery is when the body starts to repair from the trauma it has experienced.  Depending on the invasive nature of the surgery, you may end up with a lot of inflammation and pain as a result. This is what to expect:

  • Opioids may be prescribed for short-term pain control during the immediate recovery period (e.g. in hospital or just after discharge).
  • The aim is to reduce pain enough to allow movement, breathing exercises, wound care, and other recovery activities (while balancing side effects).

As You Recover

Recovery timelines vary. It’s important to follow your clinical teams’ plan. Here’s what to expect:

  • The goal is usually to taper off opioids as soon and safely as possible, moving to non-opioid pain relievers (e.g. paracetamol, non- steroid anti-inflammatory drugs (NSAIDs) e.g. Ibuprofen, Celecoxib) and non-drug strategies (e.g. ice, physiotherapy, rest).
  • Your care team may reduce the dose gradually, monitor for side effects, and assess whether continued opioid use is necessary.

*Before reducing or stopping your opioid medication, it’s important to speak with your doctor or pharmacist. Suddenly stopping can lead to withdrawal symptoms.

Dependency, Misuse, and Safety

One of the biggest concerns around opioid use is dependency or misuse.

Opioids can become addictive because they trigger the release of a chemical in your brain called dopamine, which creates feelings of pleasure and wellbeing.

If you take opioid medicines regularly, your body adjusts and you may need higher doses to feel the same effects — a process known as tolerance. Taking larger amounts, increases the risk of harmful side effects.

Here are some important things to know:

  • All opioids carry a risk of addiction or dependence.
  • Some people may begin to show signs of dependence after just a few days of use.
  • Long-term use of opioids can increase your chance of dependency.
  • Misuse (taking more than prescribed, taking someone else’s prescription, combining with alcohol or other medicines) can lead to overdose, hospitalisation, or death.

It’s essential to use opioids exactly as prescribed by your surgeon or pain specialist, to never increase the dose without consultation, and to tell your healthcare team about any side effects or concerns.

More information: “Prescription Opioids – An Overview”

What You Can Do: Tips for Safer Use Around Surgery

Here are practical steps you (or carer/family member) can take:

1. Ask Questions Before You Leave Hospital

    • What opioid (if any) is being prescribed, and why?
    • What is the plan for tapering off?
    • What non-opioid alternatives can I potentially be using?

2. Keep a Pain & Medication Log

    • Record when you take the medication, the dose, and pain level.
    • Note any side effects.

3. Stick to the Prescription

    • Don’t take more than directed..
    • Don’t skip doses without consulting your healthcare provider.

4. Avoid Mixing with Alcohol or Sedatives

5. Communicate with Your Team

    • If side effects are severe, let your doctor or pharmacist know.
    • If pain isn’t well controlled or seems to get worse, ask for a review.

6. Plan your Taper with a health professional

    • The time it takes to safely reduce (or taper) opioid use is different for everyone and depends on the specific medicine. You should never try to stop taking opioids suddenly or on your own, as withdrawal can be uncomfortable and, in some cases, dangerous.
    • When it’s time to stop, your healthcare professional will work with you to develop a gradual tapering plan — this means slowly reducing your dose over time until you can stop completely, helping to manage symptoms and keep you safe.

7. Watch for Warning Signs of Dependence

    • Craving the medication, feeling unable to stop or reduce, using it for reasons other than pain.
    • More information: “Could I Be Dependent?”

In Summary

Opioids can be useful for managing post-surgical pain, but they must be used carefully and under close supervision.

Side effects, risk of dependency, and safety concerns (especially around breathing) make it essential to have a clear plan for tapering and monitoring.

Stay in communication with your healthcare team, ask questions, and use a combination of strategies (drug and non-drug) to manage pain as you recover.

Help and Support

Help and support is always available, whether for yourself or a loved one. If you have any questions or concerns about prescription opioids, speak to your doctor, pharmacist or other trusted health care professional.

More information: “Help and Support”