From the Washington Post.
by Ronnie Cohen
Dentists who prescribe opioid painkillers such as OxyContin to teenagers and young adults after pulling their wisdom teeth may be putting their patients at risk of addiction, a new study finds. (Toby Talbot/AP)
Dentists who prescribe opioid painkillers to teenagers and young adults after pulling their wisdom teeth may be putting their patients at risk of addiction, a new study finds.
The study, published in JAMA Internal Medicine Monday, shines a light on the largely overlooked role dental prescriptions play in an epidemic of addiction that has swept the United States, leading to a record 70,237 drug overdose deaths in 2017.
“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,” said researcher Alan Schroeder, a pediatrician and professor at Stanford University School of Medicine. “Our findings should trigger heightened scrutiny over the frequency of prescribing dental opioids.”
Adolescents and young adults often are introduced to highly addictive opioid painkillers when they have their third molars pulled. Millions of Americans undergo the procedure every year, and dentists routinely prescribe opioids to the vast majority. Only recently have dentists — the most frequent prescribers of opioids for youths between the ages of 10 and 19 in 2009 — started to reconsider the use of narcotics in managing post-surgical pain.
Nearly 6 percent of almost 15,000 people between 16 and 25 years old who received initial opioid prescriptions in 2015 from dentists were diagnosed with opioid abuse within a year, the study published by Schroeder and four other researchers shows. In comparison, 0.4 percent in a similar group who didn’t get dental opioids were diagnosed with opioid abuse during the same period.
“These are kids who could have gotten Advil and Tylenol, and 6 percent showed evidence of becoming addicted,” said Andrew Kolodny, who co-directs opioid treatment research at Brandeis University. “That’s huge.”
The numbers are particularly troubling given that most people who have their wisdom teeth removed do just as well or better on over-the-counter pain relievers. An April study in the Journal of the American Dental Association found that anti-inflammatory analgesics, such as ibuprofen and acetaminophen, generally work better than opioids at easing acute dental pain.
“We certainly don’t need to expose adolescents to opioids after we take out their wisdom teeth,” said Kolodny, who was not involved with the study. “On that particular topic, the science is clear.”
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