CHAMBERSBURG, Pa. (WHTM) -- It's still not the norm, at least not most places.
But some patients -- and most young athletes operated on by Dr. Michael Day, a Chambersburg-based orthopedic surgeon for WellSpan -- are recovering without opioid pain killers.
Take Brandon Vaughn, whose senior season playing football for the Chambersburg Trojans ended abruptly in September 2021 during a home game against State College.
Day's diagnosis? "Anterior cruciate ligament rupture" -- a torn ACL. That meant surgery and then a long and sometimes-painful recovery.
"Maybe 10 years ago, what I would have done would be to prescribe enough opioids to cover any amount someone might need," Day said -- just as practically any other surgeon would've done.
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Then came the opioid epidemic and an at-first-subtle shift from prescribing as many pills (oxycodone, most commonly) as a patient might possibly need to as few as they would surely need.
The idea? "Put less opioid into the community and kind of tailor it to what's actually needed," Day said.
"So we started off with 60 [pills after surgery], and we found out that on average people are using 13. So okay, well, let's prescribe 15 pills," Day said, characterizing the first round of thinking.
Still, Day said, "I noticed that a lot of the athletes, particularly high school athletes -- they were taking one or two or three."
And even then, only because they had them, he said. Day's next thought: "There's probably a subset of people that don't need any.... So then I decided, well, let's start off with no opioid."
"We're talking about opioid free," he said.
Vaughn's reaction when Day raised the specter of a no-opioid recovery after surgery for a torn ACL?
"I had heard other people and their experiences and the type of medicines that they had to take," Vaughn said. "I didn't really know exactly that that was even an option initially, that I could just go through surgery and the process afterwards without taking opioids."
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The reaction of his mother, Penny Vaughn -- in the stands to witness the gruesome injury and in the exam room when Day explained the opioid-free recovery?
"I knew it was going to be tough without it," Penny Vaughn said. "But with him being so young, I'm like, 'Yeah, he can he can do it.'"
One benefit, among others? The complete elimination of the risk of becoming addicted. Day said some people whose lives are ruined by opioid first become exposed after surgery.
"It can all start very innocently in a way that is -- you know -- completely legal and appropriate medically," he said. "So not having that introduction just takes away that possibility."
Day said his approach remains the exception.
"It's still not standard," he said. "And I think the vast majority of [doctors] would prescribe some opioid. There's a comfort level there, both for the surgeons and for the patients."
The concern? "What if I need it? What if, you know, I'm at home and I don't know what to do and I need something for my pain?" Day said, characterizing common anxieties.
His answer: He's not doctrinaire. When he believes a patient can recover without opioids, that doesn't mean he wouldn't be willing to change course later and prescribe something. But the record of having to do that so far for patients like Brandon?
"None of them have asked for emergency opioid prescriptions," Day said. "So we've been really happy with the results there."
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