Substance Use & Surgery: What You Need to Know

Substances like recreational or illicit drugs, even if used only once in a while, can change how your body reacts to anesthesia and pain mediation. If your health care team knows what drugs you have used and how often, they can create a plan that helps keep you safe and comfortable before, during, and after your procedure.

Avoiding substance (drug) use before surgery may:

• Make anesthesia safer
• Decrease your risk of infection and speed up healing
• Lead to shorter hospital stays and prevent complications

Discussing your substance use with your health care team helps them plan safe anesthesia, effective pain control, withdrawal prevention and a smoother transition from hospital to home.

How is Substance Use Identified?

As part of your pre-surgical screening, we ask if you have used any non-prescribed substances (like street drugs, party drugs, or stimulants) in the past 12 months. If you said yes, we may ask more questions about the type, amount, and how often you use - this is only to make your care safer. Your answers are confidential and are used only as part of your health history.

Even if you used a substance just once in the last 12 months, we are sharing this information so you can make informed decisions and understand how it may affect your surgical care. This information supports conversations with your health care team, but does not replace them.

What Can You Do Before Surgery?

If you use non-prescribed substances (drugs):

• Try to reduce or pause use for at least 48 hours before surgery (longer is better). This reduces your risk of complications.
• If you use substances daily or most days, talk with your health care team. It may be safest to slowly reduce your dose to avoid withdrawal.
• Do not come to surgery intoxicated. If you are visibly high on the day of surgery, your surgery may be rescheduled for your safety.
• Stimulants like cocaine or methampehtamine carry high risks. Avoid them for at least 2 weeks before surgery. The longer you can avoid them before surgery, the safer you will be.
• Talk to your health care team for help planning your care.

Are You On Opioid Agonist Therapy (OAT)?

If you take methadone, Suboxone, or Kadian, here is what you need to know:

• Usually you should keep taking your medication as prescribed, including the day of surgery (in some cases your health care team may change your dose before surgery but they will let you know).
• Meet with your community prescriber before surgery to review your dose and make a plan for after surgery.
• If you are admitted early in the morning, arrange a "carry" dose so you do not miss your medication

If you take Naltrexone or Contrave, you may need special instructions. Ask your health care team about when to stop and restart these medications.

If You Want to Cut Back or Quit

If you use substances daily or in large amounts, stopping suddenly can cause withdrawal symptoms. Sometimes withdrawal can be dangerous, which is why a slow, supported taper is often recommended. This helps keep you safe while reducing your use.

If needed, your health care team may refer you to:

• An Addiction Medicine specialist
• Your primary care provider
• Community support services to help create a safer plan

Prevent Overdose - Protect Yourself and Others

Because some drugs may be contaminated with dangerous substances like fentanyl, it is important to:

• Pick up a free naloxone kit from your local pharmacy
• Learn how to recognize and respond to an overdose. Visit the BC Government website to learn more.

Where to Learn More

Learn more about mental health and substance use at HealthLinkBC

Visit Help Starts Here for substance use support and resources

First Nations Health Authority Information About Opioid Agonist Therapy

24-Hour BC Alcohol and Drug Info Line: 1-800-663-1441