How likely is it that brief pain medication use will trigger drug addiction? That’s the question behind a parent’s concerns:
My 19-year-old son is home on break from college and will have four impacted wisdom teeth removed next week. I am worried that he will become addicted to the opioids that are often prescribed for pain. When I expressed my concern, he became angry and said I was being ridiculous and that he would not writhe in pain when relief is available. I am not even sure the oral surgeon will speak with me because of HIPAA regulations. What can I do?
Your anxiety is understandable, and if pain relief is administered appropriately, the chances of your son developing an addiction are quite low.
But first, let’s clarify what opioids are and why they’re frequently prescribed to alleviate pain.
Opioids are a broad class of drugs originally derived from substances found in the opium poppy plant. Opioids include poppy-derived drugs like morphine (“opiates”), but also include semi-synthetic and synthetic drugs such as hydrocodone, oxycodone, and fentanyl. Opioids work on receptors in the brain to produce a variety of effects, including pain relief and euphoria. Because they are such effective pain relievers, opioids are often prescribed after surgery–including wisdom tooth extractions.
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During the 1990s and 2000s, opioids like OxyContin (a branded version of oxycodone) were overprescribed, and many people developed addictions. However, since 2021, federal guidelines have been put in place such that prescribers now receive training in how to safely prescribe opioids at the lowest effective dose, and often, for no longer than five to seven days. Furthermore, drugs like OxyContin are not typically prescribed for wisdom teeth removal–such drugs are primarily used to treat chronic pain. Instead, something like Percocet–a blend of oxycodone and acetaminophen–is the more likely choice for your son’s procedure.
So how can you stay in the loop with your son’s treatment? First, call the oral surgeon’s office and ask to be added to your son’s HIPAA form. (I did this recently; it’s a straightforward process.) Next, arrange to speak with the oral surgeon about post-extraction pain management and treatment options. Voice your concern about the risk of your son developing an addiction. Share if there is anything specific in his medical history that you want the oral surgeon to be aware of. In particular, share if there is any family history of substance use disorder.
Regarding your core concern: in most cases of addiction, it is the chronic use of opioids, not short-term use, that leads to physical dependence. Developing an addiction is rare when opioids are used for five days or less. Nevertheless, the oral surgeon will likely convey to your son (and you) the importance of never taking more than what has been prescribed, and to take the lowest possible dose, for the shortest amount of time. The oral surgeon will also suggest that your son start the pain medication as soon as the local anesthetic begins to wear off, as it is crucial to stay ahead of the pain.
After the surgery, consider calling the oral surgeon to discuss your son’s level of pain, the effectiveness of what he is taking, and whether he’s experiencing any adverse reactions.
And when it’s all over? Chances are, some pills will remain. For safety reasons, please use the Belmont Police Department’s drug disposal box in the lobby. I suggest you drop off what’s left there.
Lisa Gibalerio, MPH, is the author of the Ask Lisa column, where she answers questions from parents about how to navigate the teen and preteen years. Lisa oversees the Belmont Wellness Coalition, a program of Wayside Youth & Family Support Network. The advice provided in this column is for informational purposes only. It is not a substitute for professional care.
If you have a question for Lisa, send it to: asklisa@belmontvoice.org.
