Teens, Wisdom Teeth and Opioid Addiction

Each day in the United States, an estimated 130 people die due to an opioid overdose. Shockingly, drug overdose is now the No. 1 cause of death in people under the age of 50 in America, an increase of 200 percent since the year 2000.

Opioids naturally occur in the opium poppy plant; some opioids are derived from that plant, while others are created synthetically. Opioids are often prescribed as painkillers following surgery because of the feeling of relaxation and relief they give the patient. But although they are highly effective, opioids are also highly addictive. According to drugabuse.gov, upward of 30 percent of patients who are prescribed opioids will misuse those drugs – and nearly 12 percent will develop an addiction. Often, opioid addiction leads to addiction to stronger, more dangerous drugs such as heroin. In fact, an estimated 80 percent of heroin users started out with an opioid addiction.

In an effort to help reduce the number of opioids being prescribed and thus ending up “on the street,” organizations such as the American Dental Association and the Journal of the American Medical Association are recommending doctors, surgeons and dentists prescribe opioids sparingly.

Now, according to a study published in the Journal of the American Medical Association Internal Medicine, insurance companies may be joining the fray, aiming to reduce the number of teens prescribed and subsequently addicted to opioids. That’s because, according to the JAMA report, persons between the ages of 16 and 25 who are prescribed opioids following dental procedures are 10 times more likely to become addicted.

Dr. Randy Sanovich is a facial cosmetic, oral and reconstructive surgeon based in Dallas, Texas. He often treats teenage patients for routine wisdom teeth removal, a procedure cited in the JAMA article as a starting point for teen opioid addiction.

“Approximately 5 million wisdom tooth extractions are performed each year, and the majority of those extractions are done on teenagers and young adults,” says Sanovich. “It’s an impressionable age group whose brains are not fully developed. Adding opioids to the mix can be a very dangerous combination.”

According to Sanovich, many dentists and surgeons are now following the Centers for Disease Control and Prevention’s recommendations for first-time prescriptions of opioids for teenagers.

“The CDC is now suggesting that doctors prescribe three days’ worth or less of opioids for teenage patients,” says Sanovich. “They also suggest that doctors recommend a different combination of drugs altogether – such as a combination of over-the-counter drugs like ibuprofen and acetaminophen.”

In his practice, Sanovich takes a proactive approach to reducing patients pain without the use of opioid prescriptions. He is one of the few surgeons in the Dallas-Fort Worth area to prescribe a pain medication called Exparel. Exparel is a non-opioid numbing medication that is injected directly at the surgical site at the time of the procedure. This long-lasting medication is often so effective at managing post-surgical pain, patients do not need narcotic pain medication at all during recovery.

“We want patients to be comfortable following surgery – not to develop a lifelong addiction to opioids,” Sanovich says.

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