My brother is a recovering alcoholic. He’s going to have back surgery next week. The nurse told him he would be given a pain pump to use for the first 24-hours. This is supposed to allow him to control his pain. When he needs more pain meds, he just pushes the button. Is this really a good idea for someone who already has a history of addiction?

Back in the 1960s, studies showed that small doses of pain relievers delivered intravenously after surgery was a much better way to control pain compared with traditional methods. Since that time, the idea of pain-controlled analgesia (PCA) has evolved.

Today, the PCA system can be programmed to deliver a specific amount of pain relieving drug with a lockout interval. This means the device can be set so that the patient can’t just push the button over and over. Each dose of pain is followed by a certain length of time before the next dose can be dispensed.

Weak but effective pain relieving opioid medications can be used this way. The side effects are minimal. And unless the drug is used for long periods of time, the risk of addiction is minimal.

Some centers are also using an opioid-soaked epidural patch to help reduce post-operative pain. A small piece of fat is removed from under the patient’s skin and injected with meperidine (Demerol). This fat patch is placed over the puncture site where the operative needle was inserted into the spinal canal. The meperidine soaks into the area giving added (local) pain relief.