The dental community has been focused on training and educational opportunities for dentists to change the way they prescribe opioids for dental procedures.
For the past three years, I have been an advocate of the change, a role I did not choose: I was chosen for it.
Four years ago, my youngest son Adam died of an overdose of heroin laced with benzodiazepine after a brief addiction to heroin, which was preceded by addiction to opioid prescription medications. He was admitted for treatment in an in-house recovery program as soon as we found out about his addiction. After being in recovery for about seven months, he returned to the community with a full-time job and was taking classes at night at a local community college. He wanted to become an EMT.
Suddenly, nine months into recovery, he relapsed and overdosed.
Four days later, Sept. 30, 2014, to be exact, he died.
Adam was a generous person. As a teenager, he loved volunteering for community activities and served as a volunteer firefighter during his high school years. He also was generous in his death: Four of his organs were used to save four different lives.
Adam’s passing has been life-altering, to say the least. The unbearable grief for our family never will disappear.
Professionally, though, the experience reminded me of my past experience with my dental patients and prescribing opioids to so many patients, many of them my son’s age. It also stirred my previous interactions with patients who suffer from substance-use disorders and those in recovery.
I wanted to know more about addiction.
I enrolled in a yearlong graduate program in the field of addiction at Virginia Commonwealth University in collaboration with two other top international universities. My studies confirmed my previous lack of scientific and medical knowledge about addiction. Not surprisingly, many of my colleagues in medicine and dentistry shared these profound deficiencies.
Although my thirst for new knowledge on addiction will never end, I have embarked on a different but related journey — to share my story in the hopes that it will save your son, your mother, your loved one.
I speak about the opioid epidemic, opioid analgesics, pain management and addiction at dental schools, legislative and advocacy groups, local, regional and national dental conferences and churches.
I’m always surprised by the number of times audience members come up to me to share their own story and suffering. Yet, I’m not surprised by the ethnic, gender and socioeconomic diversity of these people.
I’m encouraged by my dental community. Young dental and medical students and young dentists and physicians diligently listen and seek guidance from my experience. Many seem to be willing to change their attitude and approach not only toward prescribing opioids, but also toward addiction in general. They accept the fact that addiction is a disease of the brain and not a moral failing.
I’m also encouraged by the energy many leaders in dentistry, such as the Virginia Dental Association, the American Dental Association, the American Association of Oral and Maxillofacial Surgeons and state and national legislators, have committed to fighting the opioid epidemic. I also am grateful to VCU for its recent steps to combat this epidemic on many fronts.
We are starting to see results.
In many states, there are decreases in the number of tablets given per opioid prescription and less opioid prescriptions are being filled. We’re starting to see a decline in opioid prescription overdoses in some states.
At the VCU School of Dentistry Department of Oral and Maxillofacial Surgery for the first six months of 2018, we observed a 70 percent decline in the average number of tablets per prescription compared to five years ago and a 60 percent decline in the number of patients receiving opioids after oral surgical procedures.
At present, only 21 percent of our patients who have oral surgical procedures receive opioid prescriptions. I should emphasize that all of our patients — even the ones who received opioid analgesics — are given or offered a prescription for a scheduled, nonsteroidal anti-inflammatory pain medication (ibuprofen) with or without acetaminophen (Tylenol).
Our records and the observation of our students, residents and faculty indicate there has been no increase in the number of patients requesting alternative analgesics other than what is prescribed. This may suggest that our new prescribing regimens are adequate for control of pain after extraction procedures.
At this point in my journey, I reflect on if and when the deaths from prescription medications will decline.
It is tempting to ask ourselves if we should celebrate our success in making progress on this issue and go no further. Can we, as health care workers, be satisfied with just decreasing the prescribing of opioids? In other words, can it be that doing right by our patients means only stopping the excessive opioid prescribing, a cause of the current epidemic?
The answer depends on whether you believe that the goal of the health care profession in the current epidemic is only to solve the current epidemic, or if the goal also includes avoiding future epidemics. It also depends on whether you agree that doing right by our patients is doing the most we can to treat their current disease and prevent any future ones, or you feel that we have to focus only on what is at hand and leave the rest to future practitioners.
To me, the answer is clear: While we should treat the epidemic now with everything we’ve got, we should do all we can to prevent any future epidemics that may come, potentially affecting our children, grandchildren and generations to come. That means, once and for all, consider and treat addiction as a disease with parity to other diseases.
Those at risk of addiction deserve our dignity and kindness and the best treatment possible. We should empathize with them if they relapse and help find a better and more suitable treatment, just as we do with other diseases.
We should fight for them, so they can make it to the next holiday or birthday, when better drugs or treatment can allow their family more time together and a stronger sense of hope for many more holidays and birthdays to come.
I hoped for the same for my son.
I only can hope now that the agony I’ve experienced won’t be in vain.
Views of opinion contributors are their own and do not necessarily reflect those of the Virginia Mercury.