Opioids in Dentistry
Over the last several years you may have noticed many news stories regarding the impact of prescription pain killers in America. Dr. DuPre՛ and I, along with all licensed dental practitioners in New York State, were recently required to take a course on the effects of opioids. The problem has become very real. The National Survey on Drug Use and Health (NSDUH) conducted by the National Institutes of Health found that in 2010 2.4 million Americans tried an opioid for the first time (1). That equates to approximately 6,600 per day and that number has surely risen in the past seven years. The CDC reported that there were 18,000 deaths due to prescription opioid overdose in 2015 (2). This number does not even include the use of illicit fentanyl.
Opioids have been in existence for over 100 years as derivatives of opium. In fact, Civil War soldiers became addicted to morphine, the first drug to be isolated from opium. Many opioids have been lab-created since this time, and their effective strength has multiplied many times over since the origin of morphine. The drug fentanyl, according to the National Institutes of Health, is known to be up to 100 times more potent than morphine. There are others that are thousands of times more potent, which are allowed for veterinary use only.
Quite unfortunately many people have turned to heroin, another opium derivative, because it has become easier and less expensive to obtain when compared to prescription drugs. Dentists and physicians often encounter people known as drug-seekers, who will go from doctor to doctor trying to obtain pain medicine. They often do not have a painful issue, but I have seen patients who have allowed a harmful abscess to remain just to have a “problem” that requires treatment with pain medicine.
At CrossKeys Dental, Dr. DuPre՛ and I rarely come across a case that requires a prescription narcotic. Ibuprofen (Advil, Motrin), Naproxen (Aleve) and Acetaminophen (Tylenol) work wonders when it comes to reducing pain after a dental procedure. Even after a tooth is extracted I will always recommend ibuprofen as a first line and very effective medication, and the patient rarely has to take the drug for more than 24 hours. Acetaminophen and ibuprofen can also be safely alternated offering a strong, but not mind-altering effect.
My hope is that if we as clinicians help to stop the introduction of these devastating drugs to our patients we will assist in ensuring that the next generation of Americans will not be gripped by the powerfully addictive nature of these drugs.
1) Misuse of Prescription Drugs, https://www.drugabuse.gov/publications/research-reports/prescription-drugs/trends-in-prescription-drug-abuse/how-many-people-abuse-prescription-drugs, Retrieved July 15, 2017
2) Overdose Death Rates, https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates, Retrieved July 15, 2017
CrossKeys Dental is located at 110 CrossKeys Office Park in Fairport. Dr. DuPre՛ and Dr. Badali provide comprehensive family dentistry and are always welcoming new patients. Visit us at www.CrossKeysDentalFairport.com for more information.
© 2017 CrossKeys Dental in Fairport, NY by Vince Badali, DDS