A recent study revealed that for many teens, opioid abuse begins with wisdom tooth extractions. The unnecessary prescriptions can lead to lifelong addiction, progressing to other opioid usages including heroin addiction. And now, insurers are discouraging opioid use for dental extractions, asking doctors to rely on Tylenol instead.
The study, published in JAMA Internal Medicine last December, found that youths age 16 to 25 who first used opioids after dental care were more than ten times more likely than their peers to be diagnosed with opioid abuse. Startlingly, opioid use disorder often emerges within just a year of getting their first prescription.
The Kansas City Star spoke with United Healthcare’s chief dental officer Ted Wong, who said that the relationship between dental prescriptions and opioid abuse makes sense. He explained that adolescents are more sensitive to drugs like opioids because their brains are developing. Opioid prescriptions for wisdom tooth procedures are common for young people, and nearly 5 million people have their wisdom teeth removed every year.
“That gave us a reason to kind of look at that high-risk population,” Wong said. UnitedHealthcare found that about 70% of their patients were prescribed opioids for pain after having their wisdom teeth removed. Nearly 45% of all opioid prescriptions adolescents took were prescribed by their dentist.
Cigna now limits dental prescriptions to a three day supply and is working to educate dentists about alternatives, such as a combination of Tylenol and Advil.
Because of this increased awareness, other insurers are also making sure dentists in their networks are prescribing a minimal amount of opioids. Cigna, for example, now limits initial opioid prescriptions to a seven day supply. Aetna has written letters to dentists who prescribe high amounts of opiates to let them know that they’re prescribing too much and recommends a seven-day prescription maximum for dental pain.
The American Dental Association has also published guidelines for dentists, including publishing guidelines that tell them to limit their prescriptions for opioids. They also recommend teaching patients how to dispose of any unused pills properly, so others don’t inadvertently abuse them.