Most people feel anxiety or fear when faced with a trip to the dentist. This is because any dental procedure is invasive and the patient is typically awake. Soreness in the mouth can linger for days after work is done. Because of this, it is not uncommon for a dentist to prescribe opiate painkillers to the patient once the dental work is done. This problem with this is that opiates can quickly become addictive, and this practice unfortunately is contributing to the opiate addiction epidemic in the United States.
On October 26, 2016, the President declared opiate abuse an addiction a national public health emergency. In 2016, there were more than 42,000 drug fatalities involving opiate overdoses. Currently, every day there are approximately 116 deaths related to opiate abuse. Additionally, 80 percent of all heroin users reported that they misused prescription opiate painkillers prior to using heroin. The problem has become so pervasive that the Department of Transportation has recently updated their DOT drug testing regulations to reduce the risk of workplace accidents in critical safety sensitive job roles.
Why are opiate painkillers so addictive? The same qualities that make them effective painkillers also make them dangerously addictive. Opiates work by attaching to receptors throughout the body and change the way the brain perceives pain. They essentially block the pain while providing feelings of pleasure and euphoria.
The results of opiate painkillers are often instantaneous, and the stronger the painkiller, the more powerful the effects. However, the body can quickly build up a tolerance to opiate painkillers, which means higher doses need to be taken to produce the same euphoric effects. Patients who stop taking the painkiller suddenly begin to feel depressed or anxious, and they need to take the opiate painkillers not just to alleviate pain or feel good, but to avoid feeling bad, or even just to feel normal. Because of the way opiates work, anyone exposed to them is susceptible to becoming addicted.
David Bell, CEO of USA Mobile Drug Testing, explains “Unfortunately, a lot of doctors don’t adequately explain the risks of opiates, and their patients, despite taking them exactly as prescribed, become both physically and psychologically addicted. When coupled with the fact that patients are sometimes cut off abruptly when their prescription is empty, rather than tapering off slowly, sometime leads to the dangerous decision to buy opiates illegally, or even resort to using heroin in its place.”
In an effort to combat this epidemic, the American Dental Association (ADA) has started to vocally make several recommendations and requirements of dentists before an opiate painkiller is prescribed. These include trying to utilize over-the-counter options before opiate painkillers are prescribed.
Studies have shown that in many cases, such as a root canal procedure, the use of OTC drugs like acetaminophen can be just as effective as an opiate in combating pain. Dentists should consider this option before an opiate is prescribed, especially if the patient is a teenager. In the state of Pennsylvania, the law now requires dentists get written permission from parents before prescribing opiate painkillers to teens. Additionally, prescriptions for opiates cannot be longer than seven days. Pharmacies such as CVS are also heeding to these recommendations and will not fill opiate painkiller prescriptions for more than seven days.
Hopefully, a patient is forthright with their dentist about any substance abuse issues the patient has had in the past, but dentists need to ask questions and have conversations about how opiate painkillers work and the possible risks involved before a prescription is written. A person who has struggled with substance abuse in the past is more likely to fall prey to a prescription opiate painkiller. Dentists need to continue their education on addictive behaviors as it relates to pain management and be prepared to counsel and instruct patients regarding the appropriate use of controlled substances, as well as provide instruction regarding how to safely secure, monitor, and get rid of any unused prescription opiate painkillers at home.
Dentists also need to remember that because their patients come from all walks of life, an opiate prescription can affect a work industry or the community at large. With regard to work, when a person suffers from an opiate painkiller addiction, he or she is endangering a plethora of people, as well as being a financial risk to their employer and everyone they come in contact with.
If a dentist suspects that a patient is suffering from an opiate painkiller addiction, it’s imperative that they point the patient in the direction of proper counseling and assistance.
Attempting to defeat an opiate painkiller addiction can be a long and painful process. Symptoms include anxiety, depression, nausea, and muscle cramping, all of which can occur just hours after the opiate use stops. The body will need time to recover. That’s why a person breaking a destructive opiate habit should never attempt the process alone.
The United States government has invested more than $6,000,000 in treatment centers and opiate abuse education centers. There are trained professionals throughout the United States who can guide patients through the mental and physical struggles of battling this disease. People shouldn’t go through this by themselves—there is help and hope.