Unused Opioids From Dental Procedures Contribute to Prescription Drug Abuse, Epidemic

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Unused Opioids From Dental Procedures Contribute to Prescription Drug Abuse Epidemic

Considerable evidence has found that those who misuse opioids obtain them from friends and family as leftover, unused medication. But now, a recent study by the University of Pennsylvania has also found that as many as 50% of the opioids prescribed for dental surgery (such as wisdom tooth removal) remain unused. That amounts to about 1 million leftover pills.

The study also found that dental surgery patients were more likely to dispose of unused medication when given information about a pharmacy drug disposal location.

Moreover, the authors believe that if dentists prescribed fewer opioids, and more drug disposal locations existed, the amount of medication falling into the hands of others would dwindle.

This past year, the Centers for Disease Control and Prevention (CDC) released guidelines which discourages opioid prescriptions for long-term pain. Indeed, there has been a significant increase in prescriptions for chronic, non-cancer pain. And there is little or no evidence that opioids work well in managing long-term pain.

Conversely, there is increasing evidence that the long-term use of opioids may cause hyperalgesia, or a heightened sensitivity to pain. Also, developing a tolerance may require the use of more and stronger drugs, which is increasingly likely to lead to life-threatening central nervous system depression and overdose.

The CDC reported that in 2014, almost 2 million Americans abused or were addicted to at least one opioid prescription drug. Furthermore, since 1999, overdose deaths involving opioids in the U.S. nearly quadrupled. These deaths involved both prescription opioids and street opioids such as fentanyl and heroin. Street drugs are sometimes cheaper and easier to allocate when the patient is unable to obtain their medication – for whatever reason.

Other Findings

According to the study of 79 dental impaction surgery patients, nearly all (94%) were given a painkiller prescription, eighty-two percent were given anti-inflammatory drugs, and 78% were given an antibiotic.

Five days post surgery, patients reported low pain levels. On average, 3 weeks after surgery patients had used less than half the pills prescribed. Only 5 of the 79 used all of their pills. That left more than 1,000 pills unused.

Co-author Prof. Elliot V. Hersh:

“Results of our study show within 5 days of surgery, most patients are experiencing relatively little pain, and yet, most still had well over half of their opioid prescription left.”

Additionally, it was found that when patients were given specific information about drug disposal, it resulted in a 22% increase in patients who used the program or stated that they planned to use it. Researchers also recommended adding more prescription drug disposal locations, easily accessible to patients.

And finally, they suggested that even a moderate reduction in the quantity of opioids prescribed for dental procedures would drastically decrease the availability of unused medication.

Prof. Elliot V. Hersh:

“Research shows that prescription-strength NSAIDs, like ibuprofen, combined with acetaminophen, can offer more effective pain relief and fewer adverse effects than opioid-containing medications. While opioids can play a role in acute pain management after surgery, they should only be added in limited quantities for more severe pain.”

The study was recently published in the journal Drug and Alcohol Dependence.

Commentary

I personally had a friend who was given opioids for wisdom teeth removal a few years ago. He did become addicted, and also ended up switching to heroin. Although now recovered, he was subsequently addicted to heroin for many years after.

~ G. Nathalee Serrels, M.A., Psychology

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