Dental Painkillers, Young Patients and Addiction
New research indicates that, when a dentist prescribes opioid painkillers to teens and young adults following wisdom teeth surgery, they are also putting those same teens and young adults at risk for addiction.
What is truly upsetting about this is that there is absolutely no need to prescribe opioid painkillers for wisdom teeth operations, especially not when over-the-counter pain relievers are said to be as effective or even more effective in addressing the acute pain that is attendant with a dental operation.
But still, the statistics continue to rise. Dentists are prescribing more opioids to teens and young adults, and this is having a poor effect on them.
Statistics and Research Data on Dental Opioid Prescribing
According to a research paper published at JAMA Network, almost six percent of about fifteen thousand young people between sixteen and twenty-five who received opioid prescriptions in 2015 were individuals who then met the criteria for opioid dependence and addiction within a year.
Conversely, a similar group of young people was studied. They were in similar age ranges and they had undergone similar operations, however, this group was not prescribed opioids. Coincidentally, only 0.4 percent of this group ended up with an opioid addiction within a year. Clearly, there is a link between opioid prescribing post-op for wisdom teeth removal and opioid addiction among those patients.
The research went on to examine health insurance claims of more than seven hundred, fifty-thousand dental patients, again between the ages of sixteen and twenty-five.
About thirteen percent of them (close to one-hundred thousand) had received an opioid prescription in 2015, with dental practitioners writing about thirty percent of them.
But that’s not all. The research project went on to examine the medical records of the fifteen thousand adolescents and young adults who received opioid prescriptions from dentists in 2015.
Just under seven percent of them received another prescription for opioids a few months later, which is a red flag for excessive opioid use. There is no reason to require an opioid prescription following wisdom teeth removal—let alone two.
More data from a sister study done by the University of Michigan points in a similar direction. According to that study, seventy-one thousand insurance claims were examined, all of which were made by patients between the ages of thirteen and thirty.
According to the claims, those who filled prescriptions for opioid pain relievers following a wisdom teeth extraction were 2.7 times more likely to fill prescriptions for more opioids long after surgical pain had subsided than patients who merely treated post-op pain with over-the-counter pain relievers. The above data conclusions come from the following:
- 1.3% of the 56,686 patients who did fill prescriptions for painkillers following a wisdom teeth removal procedure went on to misuse opioids.
- 0.5% of the 14,256 patients who did not fill prescriptions for painkillers following a wisdom teeth removal procedure went on to misuse opioids.
All of the data points in the same direction. Dentists are prescribing opioid pain relievers, and they should not be doing so.
Experts Weigh In on Their Concerns Regarding Dentists Prescribing Opioids
The news of dentists prescribing opioids to young people which in turn caused addictions among them has not been received well in the professional community. The Washington Post did an article on the issue of dental prescribing, and it culled authority opinions from top experts in the field.
According to Alan Schroeder, a pediatrician, and a professor at the Stanford University School of Medicine, “Given the gravity of the opioid epidemic, the degree of persistent use and abuse we observed in adolescents and young adults, especially females, is alarming. Our findings should trigger heightened scrutiny over the frequency of prescribing dental opioids.”
“These are kids who could have gotten Advil and Tylenol, and 6 percent showed evidence of becoming addicted. That’s huge. We certainly don’t need to expose adolescents to opioids after we take out their wisdom teeth…”
Dr. Andrew Kolodny, chief medical officer and director of opioid treatment research at Brandeis University commented on the study as well, though he was not involved in the research itself.
He said, “These are kids who could have gotten Advil and Tylenol, and 6 percent showed evidence of becoming addicted. That’s huge. We certainly don’t need to expose adolescents to opioids after we take out their wisdom teeth. On that particular topic, the science is clear.”
One of the co-authors of the study, Caleb Alexander, who is the co-director of the Johns Hopkins Center for Drug Safety and Effectiveness, also spoke out on the issue.
He said, “The key message here is we need to be careful with opioid prescribing from day one. Your child’s receipt of opioids after a dental procedure may lead to long-term use or worse.”
Alexander also speaks out on the importance of cracking down on excessive opioid prescribing, especially now that we know beyond any shadow of a doubt how dangerous opioids are:
“Historically, we’ve tended to underestimate how important the first opioid prescription can be. This new study shows that the first prescription may be terribly important because it’s a powerful predictor of long-term opioid use. We’ve tended to overestimate the benefits of opioids and underestimate the risks in so many clinical settings at great cost to public health.”
How the Dental Industry Might Adjust Their Prescribing Methods
Drug addiction is a terrible crisis for anyone who is faced with it, but it is particularly troublesome and miserable when a young adult suffers from a drug habit.
When a young person falls prey to a drug habit, they often have a more difficult time breaking away from that habit, and they sometimes do not make it.
It is easier to prevent young people from falling prey to opioids than it is to rehabilitate them off of opioids when they are already hooked.
For this reason alone, dentists need to change their prescribing trends. They need to recommend that their post-op wisdom teeth removal patients simply pick up over-the-counter pain relievers from the drug store.
There is no reason to prescribe high-strength, mind-altering, and addictive painkillers to patients who will only be in pain for a day or two. Over the counter pain relief or natural remedies are what should be used. Opioids are not the solution.
Sources:
- https://jada.ada.org
- https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2717503
- https://news.umich.edu/unwise-opioids-for-wisdom-teeth-study-shows-link-to-long-term-use-in-teens-young-adults/
- https://www.washingtonpost.com
®