Why it’s so hard to break an opioid addiction
Wisdom teeth are an expensive and painful problem for countless Americans.
Oral surgeons pull out 10 million wisdom teeth yearly, according to 2007 research. That’s roughly 5 million swollen patients across the United States, with the cumulative medical cost totaling more than $3 billion every year.
But a new study published in JAMA Internal Medicine finds that the surgery can bring more than pain and medical bills: Teenagers are at a significantly heightened risk for opioid addiction after undergoing wisdom tooth removal surgeries that come with opioid painkillers to ease their recovery, according to Stanford University researchers.
“That’s pretty alarming,” the study’s lead author, Dr. Alan Schroeder, a clinical professor of pediatrics at Stanford, said in a statement.
The study looked at 2015 data on almost 15,000 young people who were privately insured, and who ranged in age from 16 to 25 — the ages at which wisdom tooth removal is most common. All of those young people had been prescribed dental opioids, the average being 20 pills per patient.
Nearly 7 percent of the young people were prescribed even more opioids between three months and a year after their initial dental prescription, and nearly 6 percent were actually diagnosed with opioid abuse in the year after the first dental opioid was prescribed to them, researchers said.
“These are kids who could have gotten Advil and Tylenol, and 6 percent showed evidence of becoming addicted,” said Andrew Kolodny, a Brandeis University opioid treatment researcher, according to the Washington Post. “That’s huge.”
Even more alarming? The youngest people included in the study could be at the greatest risk.
Those between 16 and 18 were “significantly” more likely to suffer persistent opioid abuse compared older patients ranging in age from 22 to 25, researchers said. Researchers said the young females in the study were more likely to have persistent opioid use as well.
The rates of opioid use and abuse in the young people prescribed dental opioids were markedly higher than in a control group created for the sake of comparison, researchers said. Some young people were excluded from the study: those hospitalized in the week before the opioid prescription, those who had already been prescribed another opioid and those diagnosed with opioid abuse in the previous year.
Dentists commonly prescribe opioids following wisdom tooth extraction. According to the researchers, 75 percent of those prescriptions are for hydrocodone-acetaminophen, known under brand names like Vicodin.
A study published earlier this year in the journal JAMA found that wisdom tooth removal that included opioid prescriptions gave patients almost triple the risk of “long-term” potential opioid use, McClatchy reported.
“We hope that our study will make my fellow dentists think twice about removing wisdom teeth, and to more strongly consider non-opioid solutions,” Romesh Nalliah, a dentist who worked on the earlier JAMA study, said in a statement.
The 15,000 young dental patients who were included in the Stanford study published Dec. 3 came from a broad dataset including 750,000 people, 13 percent of whom had at least one opioid prescription that year, researchers said.
Dental workers wrote 30 percent of those prescriptions overall, researchers said.
Schroeder said that even though wisdom tooth removal is widespread, it’s actually not that well-studied. That means it’s possible dentists do more harm than good by erring on the side of removal in cases where wisdom teeth aren’t diseased.
“I think we should ask, No. 1, Why are we prescribing such a high quantity of opioids so frequently?” Schroeder said. “And No. 2, Are all the procedures that are driving these opioid prescriptions necessary?”