Grab a Slush Puppie and Remote and Push Through the Pain!

My head was a little swimmy. I was a little nauseous. My face was numb. It felt like I had on a pair of those wax lips you could buy as I could touch them and only feel a slight pressure in recognition of my finger. The voices in the car were audible and clear but for some reason, I didn’t have any interest in their words. I knew the next stop would be a mildly busy, low-end gas station near the corner of Oak Park Boulevard and First Avenue.

This was the only place in this part of town that had what I needed and we all knew it. I would get it and then take it home and slowly consume it. Savoring it, as I knew that the pain would wash over me as soon as the beads of sweat started weeping out of my forehead and beading on my upper lip. I knew that I would have to knuckle down and try to concentrate on something other than the hurt, and that is what I would do. I would lie on the couch, trying to be motionless.

Maybe the oscillating fan would be pointed in my direction to help with the hot flashes, but I couldn’t allow that for long, as just the wind felt like electric jolts across my cheeks. I would savor that last bit of that grape Slush Puppie that I had gotten from one of the last stores that sold them before mom took me home with her, put me on the couch and gave me the remote. A rare, pitiful luxury.

I just had a dental procedure. Dr. Neil said that everything went fine and when the sedation and Novocain wore off it was going to “hurt like the dickens” but that it would be better by tonight and then maybe I could get some soup down.

Mom might need to pack me a “soft” lunch for school tomorrow. Then he sent me off with a discount coupon for the Slush Puppie and told me to take it slow and let the freezing cold drink help with the throbbing as it also handled most of the swelling. Awful! Right?

Where are the pain pills? There were none. Dr. Neil could not justify administering an opiate to a teenager with moderate short-term pain, spiking at severe, that could be buffered with ice packs and aspirin. That was then but that is definitely not now.

A new study has found that dentists are among the leading prescribers of opioids for pain relief and that their prescriptions after tooth extractions are often too long and for too many pills. The middle ground prescription is for 24 tablets of 5mg of hydrocodone. So that means that half those included in the study were getting more than that.

The co-author of the study, Brian Bateman, MD-associate professor of anesthesia at Harvard Medical School says that:

“We have gotten away from thinking about opioids as dangerous medications. Dentists may not be as conservative as they need to be with respect to using this medication…”

The study also found that 61% of adolescents issued a script for opioids, filled it. If a patient is getting the above prescription and taking four pills a day, that is a one week supply. Dr. Bateman’s recommendation is maybe a few pills for the first day and then anti-inflammatories.

Dr. Roger Fillingim, Ph.D. of the College of Dentistry at the University of Florida in Gainsville has pointed out that studies support that ibuprofen alone is similarly as effective to ibuprofen combined with opioid medications. When medications are prescribed in excess of what is needed, it creates leftover pills. This becomes a major source for misuse.

A Youth Opioid Survey done by the Christie Foundation states that 49.5% of the respondents said they could get pain pills within 24 hours if they wanted and that the most common sources were the medicine cabinets of friends and parents. Many of these youth are familiar with “pain pills” from their own experience with medical and dental procedures and almost 60% say they thought prescription pain medication was less risky than heroin when taken for a non-medical high.

Despite the reality that heroin and pain medications have very similar effects on the body and mind. 1 in 10 say they would take a pain pill that was not prescribed to them but only 1 in 20 would take it if it were known as a “heroin” pill. The trust that we put in our doctors and dentist as to the safety of the medications they prescribe us has to be matched by the responsibility they take in prescribing them. We have our own responsibility in understanding what we are being fed, and if it is even necessary.

As Dr. Fillingim points out:

“…prescribe the best thing for that particular patient at that particular time that will have the least side effects for the patient, and ultimately the least side effects for society.”

Grab a Slush Puppie and the remote and push through it!

Citings:

Youth Opioid Survey: Attitudes and Usage Executive Summary; The Christie Foundation

Opioid Prescribing by Dentists; painmedicinenew.com

Dentists Work to ease Patients’ Pain with Fewer Opioids; Health New NPR televised

Misuse of Prescription Drugs: Adolescents and Young Adults; National Institute on Drug Abuse