Why are IV analgesics not harmful when used for surgery?

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Why the huge difference between a single small dose vs. what we typically know as dependency inducing? Is there even a slight risk of dependency after surgery? (Assuming the analgesic is only used during surgery, and not taken afterwards for postoperative pain)

Note: Harmful is not the word I was looking for, but I had to reword my post several times to stop it from being deleted

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7 Answers

Anonymous 0 Comments

They are. That is why anaesthetists have a specialist training program after medical school.

You are closely monitored with all sorts of machines that go ping, have machines that can breath for you if you stop, and medication that can reverse drug effects rapidly on hand.

Would really not recommend surgical anaesthesia be given by a rando. You’ll die.

ETA addiction and tolerance are generally physiological issues related to upregulated metabolism or reduced receptors or similar. This takes time and reverts to normal if exposure is withdrawn, so single doses won’t result in physiological dependence.

The other part of addiction is psychological craving. A single dose could give an intense high that a person desires strongly so will chase more. If you’re asleep when exposed, this probably won’t be a thing.

Anonymous 0 Comments

It takes more than one dose and more than a few weeks of using opiates as prescribed to develop a physical dependence that would result in withdrawal if stopped.

Anonymous 0 Comments

r u thinking about something like ketamine/special k? its the only drug I can think of that is a well known street and anasthetic drug

Anonymous 0 Comments

In medicine, we have what’s known as the Benefit-Risk Ratio. There is not a single substance out there, even a beef hotdog, that does not have a risk or potential danger. You could choke and die from it; this has happened before and will happen in the future.

Highly Trained Physicians are paid to judge this ratio and manage the potential risks. For most procedures, the Benefit-Risk Ratio (BRP) is usually great.

#Can opioids in surgery be harmful to you? Absolutely. However, the benefit is deemed higher than the risk

Anonymous 0 Comments

when used for short amount of time for pain control, like during and after surgery, dependency rarely occurs.

When used recreationally and for long period of time, the risk of dependency increases dramatically.

the high dose of narcotics doctors give you is so short lived that people don’t normally have the chance to get addicted.

Anonymous 0 Comments

I assume you mean opioids? “Harmfull” is not a good term, opioid don’t do any harm at correct dosages. That’s why they are absolutely ubiquitous in medicine and considered an essential medication to have. They are even less harmful than OTC medication like acetaminophen which is rougher on the liver. They require careful control of dose, but at that dose they are very safe and not damaging whatsoever.

If you also just mean “potential for tolerance, dependence, and addiction”, all that has to do with extended use over time and only addiction itself is technically harmful. There is basically no chance for you to.build any of those from a single event, whatever the dose. Opioids can’t magically force addiction on you, and dependence needs time to physiologically happen.

There are also weird beliefs about specifically fentanyl due to the issues with street drugs, where people act like it is a scary poison or something, but I won’t assume you meant that.

If you meant some other analgesic or some other definition of harm though let me know.

Anonymous 0 Comments

There are good explanations in this thread, and here’s a simple explanation for why long term use leads to dependency. For example, opioids block dopamine, an important messenger between the cells in your brain. They clog up the dopamine receptors which has all sorts of effects. In long term use, your body noticed that your receptors are always being blocked and tries to fix this so it can get back to functioning normally.

If half of your dopamine receptors are always blocked then what does your brain do? Make twice as many dopamine receptors! But now anytime you’re not on opioids you have twice as many dopamine rectors than your body would normally have, so the “I’m happy signal” is only half as strong as it should be. The “relax muscle” signal is only half as strong as it should be, so you get full body severe cramps. Dopamine has all sort of effects, including in the digestive system, so all the messages your body usually sends are thrown off.

So long term use alters the way you cells communicate, but with just a single use your body never needs to adapt to a new normal, but may adapt only very slightly so that the first high is the strongest ever felt.

There are lots of different types of medication that can be used as anesthetics, and they can effect different neurotransmitters in different ways. But the addiction effect is that regular drug use forces your body to send/destroy/receive neurotransmitters differently, and these changes are very unpleasant when not using the drugs. There are psychological components to addiction as well.