Dentists and Pain Killers

What Are Opioid Medications?

Opioids. We've heard a lot about them in the media recently. What are opioid medications exactly, and why is a dentist talking to you about them?

Opioid medications are a class of pain medications that can both be very effective at treating pain, and highly addictive. You've probably heard of Oxycodone, hydrocodone or morphine, all commonly prescribed opioid medications. When used in the correct way they can be incredibly effective. However when they are abused they can cause addiction, overdose, and death.

Dentists regularly prescribe pain medication to help patients who have been in pain, or who have had dental procedures that could cause pain. As a dentist, my patient's comfort is incredibly important to me. But it's also important for me to be mindful of the effects of pain medication, and the incidence of addiction to any pain medication I might prescribe.

The Good, The Bad and the Ugly

Pain medications can be a huge help for those who suffer from chronic pain, or for those who need help controlling pain. However, the effectiveness of these types of medications can be overshadowed by the effects these medications have had on our country. In the United States, it's estimated that there are 2.1 million people who are addicted to pain medication. That's a nearly 5x increase from 1999.

It's tempting to think of drug addiction as a "big city" problem, but here in Montana, we're certainly not exempt from the opioid epidemic. Drug overdose deaths are the third leading cause of injury-related death in Montana. Since 2000, the rate of prescription drug overdose deaths has doubled, in Montana, with more than 700 deaths from prescription opioid overdose alone. In 2017, the state of Montana announced that it was suing Purdue Pharma LP, the maker of OxyContin, on claims of misrepresenting the likelihood that long-term use of painkiller would lead to addiction.

Why has this happened? The rise of addiction and death caused by pain medication can be correlated to the rise in the distribution of pain medications. In years past, there was perhaps too much focus in the healthcare community on the capabilities of opioids to relieve and manage pain, and too little focus on their potential to cause addiction.

It is important to note here that heroin is an opioid, which is not prescribed to any patient, but it is included in some opioid statistics. If you are interested in more statistics about opioid addition and usage click here for the Centers for Disease Control (CDC) statistics on the increase in opioid usage as well as the effects it has had on our country.

Changing Guidelines & Alternatives to Opioids

Recently the CDC released new guidelines for the usage and prescription of opioid pain medication. The actual recommendations and the full article can be found here. The goal of these recommendations is to stop the overuse of these medications, manage the expectations and possibility of addiction to opioid usage and to use other methods of pain control when possible.

There is evidence that supports the position that better pain control can be achieved with over the counter medication when taken correctly and it has way less possibility of addiction.

I was recently talking with my older brother, who went through dental school about a decade before I did. In comparing our training, it's clear that there's been a significant, recent shift in the way that dentists and other healthcare professionals are trained in the use of opioids. I was lucky enough to go through dental school at a time when the curriculum included a more comprehensive look at the efficacy and dangers of opioids and a focus on alternative pain management strategies that effectively manage pain without the risk of addiction.

Talk with your doctor about other ways to control pain without using a narcotic or opioid medication. A summary of the evidence supporting this can be found here.

What can I do?

There's no quick or easy solution to the opioid epidemic. But, there are things we can all do to help. As a patient, be vigilant with your medications. In Montana, over 15% of high schoolers reported having taken a prescription medication without a prescription in their lifetime

If you have been prescribed an opioid medication, keep in it a non-visible location and count your medications periodically to ensure no one has taken any.

When you're through with it, discard the medication in the correct way, not just in the trash can. A list through the FDA on how to dispose of unused medications can be found by clicking on this link.

Always take the medications in the way and in the dosage that you were instructed to by your dentist or doctor. If you have questions on how you are supposed to take a specific medication, just ask. Your pharmacist, doctor or dentist will be able to give you the clarification that you need. Providers need to follow the guidelines set out by the CDC and to be extra vigilant about what you are prescribing and who you are prescribing to.

Why Does Dr. Bowen Care?

As a dentist, I want to do my best to ensure my patients get the best care they can get. This comes through educating myself and ultimately educating my patients. I care about the health of your teeth, and about the health of the communities where we've all chosen to make our lives, and raise our families.