Opioid prescriptions for wisdom tooth removal increase addiction risk

[roethlisburger]

@“Cardinal Fang”

@roethlisburger, I’m not following your argument here. Of the young people who got the opioids for some sort of dental issue, in the following year, almost six percent got some kind of treatment for opioid abuse. In my view, this is horrible.

First you tried to explain this away by saying it could have been the young people who got dental treatment for some other issue that got addicted, but the people who got opioids didn’t addicted. This has two problems. It seems unlikely to me that so many young people have dental problems that are not wisdom teeth and that are thought to require opioids. Moreover, if there were so many young people who had non-wisdom-tooth dental problems, and almost all of them who were prescribed opioids ended up addicted, that would still be terrible and would be an appalling indictment of dentists. What, you’re saying that dentists give opioids to young people with non-wisdom-tooth pain, and all of them get addicted, and the dentists didn’t notice or didn’t care? That strains credibility.

Now you’re saying… what are you saying? The problem here is not the people getting two opioid prescriptions in a year. The problem is the 6 in 100 young people getting one opioid prescription and subsequently getting addicted that year, whether because of that first prescription, or possibly because of a second prescription. We don’t know how many of the people who got two prescriptions got addicted. They might overlap totally or not very much.

If the study was done properly, and trying to measure the effect of opioids, given for wisdom teeth removal, it should have excluded anyone who got opioids for any reason other than wisdom teeth removal. The 6.9% of people given opioids at 90-365 post-surgery should have been excluded from the study. If you did that, and excluded everyone given opioids for a reason other than wisdom teeth removal, I bet the association between opioid abuse related diagnosis and opioids for wisdom teeth removal would be close to zero. I can’t say for sure what the results would be if you redid the study correctly. What we can say for sure is this study is junk and should have never passed the peer review process.

[lookingforward]

I’m for “better safe than sorry,” in this case. Give a 3 or 4 day Rx and if days 4+ are needed, issue another Rx for a few days.

They don’t have to set a higher number on the off chance more are needed. Nor do I think we should say, So What?, about those leftovers.

Why not discuss this when planning the procedure or when he/she hands over an Rx for more than a few days? We aren’t helpless to say something.

[roycroftmom]

There are millions of Americans addicted to opioids. I seriously doubt whether the dental industry is a major contributor to that problem, as opioid cases are highest in states not known for dental excellence, including West Virginia and Maine, and among Americans aged 25-50, so not likely wisdom tooth related. It is a serious public health crisis that merits a serious response on addiction, not a flawed and alarmist study.