Tag Archives | narcotic

What Can a Surgeon Do to Prevent Opioid Abuse

An interesting article titled “The Surgeon’s Roles in Stemming the Prescription Opioid Abuse Epidemic” written by James Hupp appears in the 2016 Journal of Oral and Maxilofacial Surgery (vol. 74, pp. 1291-1293). The article describes the current challenges oral and maxilofacial surgeons are facing when it comes to prescribing opioids. This is because regulators and politicians are getting involved due to their perception of an opioid abuse problem. He mentions that Congress is considering legislation to address prescription drug addiction problems. The author wants surgeons to remember that there are legitimate reasons for giving patients who have had oral surgery such as wisdom tooth extractions an opioid medication.  Pain that interferes with a patient’s usual routines, their ability to consume enough fluids and calories, or their ability to sleep often requires a narcotic until the pain subsidizes. As such these patients should be prescribed opioids and surgeons ability to do so should not be taken away. Even so the author encourages surgeons to raise one’s threshold for using very potent narcotics, and potentially limit the number of doses prescribed to patients. In the article the author says “First, there is more and more data showing that many patients receive more potent and more doses of opioid medications than they need […]

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Comparing Narcotic Prescribing Habits For Oral Surgeons in the U.S. and Canada

In a previous blog post titled “Do Oral Surgeons Prescribe Too Many Narcotics for use after Wisdom Teeth Removal?” the issue explored was that of whether or not oral surgeons prescribe more than an adequate amount of narcotic pain killers to young adults after wisdom teeth extraction. The article that found around 25% or so of the study respondents prescribe what the authors of the article declared as too many narcotics to control pain which opened the possibility of non-medical use. A new article titled “Comparison of Narcotic Prescribing Habits and Other Methods of Pain Control by Oral and Maxillofacial Surgeons in the United States and Canada,” sought to explore whether Canadian oral surgeons have similar narcotic prescribing habits. This article was written by Bruce R. Pynn and Daniel M. Laskin and appeared in the December 2014 issue of the Journal of Oral and Maxilofacial Surgery (vol. 72, issue 12). In this article an 8-question survey similar to the one used in the previous 2013 study was sent to the 336 members of the Canadian Society of Oral and Maxillofacial Surgeons. A total of 158 surveys were returned (47% response rate) with 136 of these fully completed. Some of the […]

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What to Do about Patients Who Call After Hours Wanting Prescription Drugs

An interesting article titled “Addressing after-hours requests for prescription drugs,” appears in the April, 2014, issue of  JADA written by G. J Muller II (vol. 145, no. 4, pp. 389-390). The article discusses how the oral and maxillofacial surgeon has had several instances of after hours or weekend phone calls from people claiming to be current or past patients who have had a sudden onset of a toothache and want narcotic pain medication. The surgeon says that the people always agree to be seen in his office the next day or following Monday if it is a weekend. However, often the person will not follow up with the surgeon and not show up for the appointment after having received the medication. The surgeon says occasionally he checks if the person is a patient of record and sometimes the person is not, other times it may have been someone who was last seen a long time ago. The surgeon is concerned that many of these people who call are drug seekers and are not legitimate. In the article, tips to handle such a situation are discussed. The first thing to determine is if the person has an emergency. This is easy to […]

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Do Oral Surgeons Prescribe Too Many Narcotics for use after Wisdom Teeth Removal?

A new article published in the Journal of Oral and Maxillofacial Surgery is titled ” Narcotic Prescribing Habits and Other Methods of Pain Control by Oral and Maxillofacial Surgeons After Impacted Third Molar Removal,” by Ibrahim Mutlu, A. Omar Abubaker, and Daniel M. Laskin (vol. 71, pp. 1500-1503, 2013). The article explores the issue of whether or not oral surgeons regularly prescribe more than an adequate amount of narcotic pain killers to young adults after their wisdom teeth extraction. It has been believed by some that the narcotics given by oral surgeons for wisdom teeth removal can be a source of using narcotics for non-medical uses. In this article a 8 question survey was sent to 100 randomly selected oral and maxillofacial surgeon members of the American Association of Oral and Maxillofacial Surgeon (AAOMS). The questions were related to whether narcotics were typically prescribed to patients who had impacted wisdom teeth removed, the dosage prescribed, and number of tablets prescribed. In addition, the oral surgeons were asked about non-narcotics prescribed to patients. In all 600 questionnaires were sent to oral surgeons and 384 of them were completed and returned. The most commonly prescribed narcotic was found to be hydrocodone with […]

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