When you are a recovering addict in the methadone clinic and have to have surgery what do you do for the pain? and to add to the problem you have a large tolerance built up by the pills you where on and now the methadone you take to get your self clean is

Consider : Consider medical acupuncture. There are a number of anesthesiologists in the us that now practice acupuncture.

This : This seems worse than it is. There are an awful lot of recovering (and nonrecovering) addicts in the world, and some of them need surgery every day. Anesthesiologists are trained to manage surgical pain, and we are comfortable evaluating and treating pain in opioid-tolerant patients. Anesthesiologists may use higher-than-usual opioid doses, add other agents that make the opioids work better, or include multimodal therapies such as nerve blocks or epidural analgesia. All of these possibilities can be discussed with the anesthesiologist before surgery -- and should be. You should know that although the anesthesiologist manages pain in the preoperative area, the operating room, and the recovery room, most of the time the surgeon manages pain once the patient leaves the recovery room. So you should discuss your concerns with the surgeon as well. Finally, depending on the surgery, the hospital, and the length of the hospital stay, in some cases it may be appropriate to ask if there is a pain specialist who can visit you in the hospital. These are anesthesiologists (or sometimes other specialties) who have subspecialty training in managing acute and chronic pain. Some surgeons find them helpful in managing the pain of patients with opioid tolerance or other complex issues. I hope you find this helpful -- and i hope you are feeling better soon.

Ask your: Anesthesiologist about intra-operative use of ketamine. It works well in opiod tolerant patients.