Use and Abuse of Prescription Painkillers – Dentists, Drugs and Dependence

Happy Canada Day. (Dr. Noorali Bharwani)
Happy Canada Day. (Dr. Noorali Bharwani)

NBC News called it “The Deadly Triangle: Dentists, Drugs and Dependence.”

In the U.S., about five million people each year have wisdom teeth removed. Many of them are prescribed Percocet, a commonly used painkiller for post-surgery discomfort. But most patients are never warned that Percocet has the potential to make patients dependent on the drug. It is very addictive.

Percocet is an opioid, a class of drugs that chemically follows the same nerve pathways as heroin, eliciting a sense of euphoria. Examples of weak opioids are – codeine and dihydrocodeine. Examples of strong opioids are – tramadol, buprenorphine, methadone, diamorphine, fentanyl, hydromorphone, morphine, oxycodone, and pethidine.

Recently, a Harvard research team reported in the Journal of the American Medical Association (JAMA) that dentists are among the leading prescribers of opioid analgesics, particularly for surgical tooth extractions. The most revealing aspect of the study was that the highest number of these opioid painkiller prescriptions were for teenagers, aged 14 to 17 years old, closely followed by young adults 18 to 24 years, says the NBC News.

Opioid abuse has sky rocketed.

Some patients and certain conditions do need strong painkillers. When used properly, prescription drugs can help. But, there are many dangerous and unpredictable side effects associated with abusing prescription drugs including addiction, overdose and death, say Government of Canada website on prescription drug abuse.

Besides opioids (used to treat pain) there are other prescription medications, which can be addictive. For example benzodiazepines (used to treat anxiety and sleep disorders), and stimulants (used to treat attention deficit disorder).

When an individual intentionally takes prescription drug for recreational purposes to get high or change mood then it is called drug abuse.

Prescription drug abuse is a growing public health and safety problem in Canada, particularly among youth. In the 2012 Canadian Alcohol and Drug Use Monitoring Survey, approximately 410,000 Canadians reported abusing prescription drugs like opioid pain relievers.

The abuse of prescription drugs has harmful effects on teens’ health. They are especially vulnerable because their bodies and minds are still developing. It can damage a teen for life.

Psychoactive drugs change brain function and results in alterations in perception, mood, or consciousness. These drugs are the third most commonly abused substances, after alcohol and marijuana, among Canadian youth. Last year, over 80,000 Canadian teenagers used prescription drugs to get high, even though it can be very dangerous.

In Alberta, since 1986, the College of Physicians and Surgeons (CPSA) started the Triplicate Prescription Program (TPP) – considered an important tool in reducing the misuse and abuse of prescription medications. TPP collects prescribing and dispensing data for listed drugs. When the data meet certain criteria, physicians and others involved in the care of the patient are alerted, provided with information and directed to resources to support them in providing safe care.

So the TPP program has been in force for 30 years. Has this put a dent in the use and abuse of narcotics and other drugs amongst vulnerable population of Alberta? I hope so but I don’t have the numbers.

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