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Prescription Drugs

Are Dentists Playing a Role in Our Opioid Crisis?

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Wisdom teeth extractions have become an everyday practice for dentists in America.  85 % of people are said to need their wisdom teeth removed in their lifetime-most often people ages 17-25.  Recently scientists have suggested that there may be a connection between opioid abuse and being exposed to opioids through your dentist-often related to wisdom teeth extractions.

The Opioid Crisis

President Trump declared the opioid crisis a Public Health Emergency in the U.S. in 2017.   Many American’s saw loved ones overdosing on opioids. Of the 72, 000 drug overdoses in 2017, 60,000 of those are attributed to opioids-and the numbers have continued to rise.  In 2016, there were 63,000 drug overdoses resulting in death, creating a ten percent increase in just one year.  The spike in fatalities may be associated with a specific opioid: fentanyl.  Fentanyl alone was reported to cause about 30,000 deaths in 2017. Astonishingly, before 2014, fentanyl was only reported to of caused about 5,000 deaths annually.  It is considered 50 times stronger than heroin and is being used across the country.  It is cheap and often cut with drugs like heroin.  Too often the consumer does not know there is Fentanyl in their drugs and will overdose- mistaking the potency of the opioid for something weaker.

Research Provides Insight

Research is being performed every day to help provide insight to opioid abuse. Research is also being used to help better strategize a plan to combat the opioid crisis.  For these reasons, researchers at Stanford University performed a study dedicated to understanding if young people being exposed to opioids from the dentist have a greater risk of developing an opioid addiction within a year.

A group of about 45,000 people’s medical records were studied.  They compared patients 16-25 years old who had been to the dentist in 2015.  15,000 of them had been prescribed opioids from the dentist-compared to an additional 30,000 people who had not received opioid prescriptions.  Within a year’s time, 5.8% of the 15, 000 people who were prescribed opioids had developed an opioid abuse problem that was diagnosed by a doctor.  While the control group only saw 0.4 % of their patients receive an opioid abuse diagnosis from a doctor.

These results absolutely suggest that exposure to opioids through the dentist to our young adults potentially creates a higher risk of developing an opioid dependency.

Do We Need to Remove Our Wisdom Teeth?

Furthermore, additional research has been performed that suggests that wisdom teeth removal may not even be a necessity unless they are causing pain.  It is not certain how this will affect the long-term health of your teeth though, and more evidence will need to be provided to determine if the extraction of impacted wisdom teeth is medically necessary.

A Call to Dentist to be More Cautious

Regardless of whether wisdom teeth extraction is needed in all cases, dentists are advised to consider the use of other non-opioid medications to treat pain in young patients.  Drugs like acetaminophen or NSAIDs can be equally effective treating pain from dental procedures.

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Prescription Drugs

Senate Bill May Give More Authority to the FDA for Drug Recall

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A bill has been introduced into the Senate that would allow the US Food and Drug Administration the ability to recall medications that are unsafe for consumers. Currently, the FDA is only allowed to recommend a recall rather than initiate it.

The FDA publishes safety alerts for both prescription drugs and over-the-counter medications that may be unsafe. Also included in this list are products that are regulated, such as hand sanitizer. An example of the need for this kind of intervention came about in recent months when the FDA issued a recommendation that more than 100 hand sanitizer products be recalled because they contained a toxic chemical known as methanol. Some of the companies did not comply with the recommendation.

The bill was introduced by Senator Gary Peters who is a Ranking Member of the Homeland Security and Governmental Affairs Committee. Known as the Safe Drugs Act, many health care providers, hospitals and other facilities back the bill. While most companies generally follow the FDA recommendations and issue a voluntary recall, some companies in recent past have failed to do so, which many organizations believe put consumers at risk.

Hand Sanitizer Recall

In recent months, several recall notices have been posted for medications and drug-related products. One of the most well-known is the hand sanitizer issue. What started at around 100 products has now expanded to almost 200 items. According to the FDA, if someone were to drink the hand sanitizer or swallow it, they could have serious health issues, including blindness and even death.

The need for hand sanitizer has exploded with the recent pandemic. As a result, many companies rushed to capitalize on the situation and brought a new product to market. However, many of them are unsafe. These products can be found online as well as in major retailers like Walmart, Target and other national chains.

Along with the danger of swallowing, methanol is also toxic if it is absorbed into the skin, which would certainly happen with hand sanitizers. Many of the manufacturers are based in Mexico, but some products were made in the US.

An import alert was issued earlier this year to prevent the products containing methanol from entering the US. The agency also warns not to be fooled by products that claim to be FDA approved as none have been. They also say to be wary by products that say they can protect a person for up to 24 hours, as this is untrue as well.

As this issue indicates, the FDA has limited authority to stop products from being sold that are dangerous to consumers. However, new legislation would give the agency more authority to remove unsafe products. Several people have died from the hand sanitizers that were part of the alert. The bill has not been passed as of yet due to the Senate’s recess.

Until given more authority, the FDA will continue to monitor drugs and other products on the market and test them for safety. Any found to be unsafe will result in a recommendation for a recall.

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Birth Defects

New Data Links Antidepressants to Birth Defects

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A recent study shows that women who took certain prescription antidepressants during their pregnancies had a higher rate of birth defects in their newborns. Some of the medications included in this study were Paxil, Prozac and SSRIs.

The study focused on medications given early in the pregnancy, which created a higher risk for certain defects in the newborn. For instance, Prozac or fluoxetine was linked with anomalous pulmonary venous return. The study showed the risk for this condition more than doubled in mothers given the medication. Venlafaxine, which is Effexor, showed a higher risk for defects to the oral cleft, along with gastroschisis and neural tube defects as well as heart defects.

Prescriptions for antidepressants with pregnant women are more common than might be expected. The study showed that up to 8 percent of pregnant women have been prescribed these medications. Researchers accounted for the underlying mental health conditions when studying the effects of the medications. According to the researchers, the results from the study indicate that the birth defects may occur because of the medications, but further research must be conducted to gain a full assessment.

Evidence provided for the use of antidepressants indicates that the effects of the medications is less severe than the effects of untreated depression, according to some scientists. However, it is hoped that the study will trigger more discussions between the doctor and mother about the use of antidepressants during pregnancy.

Details of the Study

The study used data from 1997 to 2011 through the National Birth Defects Prevention Study. The researchers compared data from mothers who had babies with defects and those that had none. Those who participated in the study self-reported when they used the medications, how frequently, duration of use and when they stopped taking the medications.

Babies who had genetic disorders were eliminated from the study along with others who had abnormalities not related to the study. Adjustments were made for race, ethnicity, BMI, alcohol or tobacco use. When the study was completed, it showed that 30,630 mothers had a baby with a birth defect. Around five percent had used antidepressants early in their pregnancy.

Of those women with birth defects in their babies, they were more likely to be older and have had at least one other living child. They were more likely to be non-Hispanic white and to have used alcohol or tobacco during pregnancy.

The research was conducted by the National Center on Birth Defects and Developmental Disabilities in Atlanta along with specialists who came from JAMA Psychiatry. Over 40,000 participants were included in the study. Researchers recommend that doctors discuss these risks with their patients along with the benefits of taking the medications. It is important that patients and doctors make informed decisions together for the health of the mother and the infant.

More research is needed to determine future guidelines on these medications in use by pregnant women. However, it is important to be aware of the potential for health concerns when considering pregnancy or while pregnant.

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Prescription Drugs

Some Heart Meds May Come with Extra Risk

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Beta blockers are often prescribed for high blood pressure, especially if the patient has suffered a heart attack. A new study shows they may not be as effective as once thought.

The study was done in Italy at the University of Bologna. According to researchers, it appears that these beta blockers may not be as effective in women patients as they are in men. Data indicated that women had a higher rate of heart failure than men when they had angina or a heart attack.

The study had 14,000 participants from 12 different countries in Europe. Each one had a diagnosis of high blood pressure, but none of them had a heart disease diagnosis. According to the research, women may have an almost five percent higher risk for having heart failure after a heart attack when taking beta blockers. For those who didn’t take the medications, the rate of heart failure was about the same for both men and women.

Researchers don’t know the cause for this possible difference. One theory is in the interaction between the beta blockers and hormone replacement therapy. It is obvious that more research focused on women is needed. According to doctors and scientists, research often leads to blanket statements that may not hold true for both men and women.

Women present differently with heart issues than men. They also have a unique physiology from men, which leads to the idea that they may react differently to the same medications as men. Other researchers say that beta blockers pose a risk for anyone, whether the patient is a man or woman.

How Beta Blockers Work

Beta blockers do their work by blocking the transmission of the hormone epinephrine, which is better recognized as adrenaline. These medications slow down your heart rate as well as the force with which it beats. The result is that your blood pressure is also lowered.

The medications have a secondary job which is to open up the veins and arteries for better blood flow. Not all beta blockers work the same. Some focus on the heart rate while others also impact the blood flow. Some popular brand names of beta blockers include Sectral, Corgard, Zebeta, Toprol XL, Tenormin and Inderal.

Beta blockers aren’t usually the first line of defense against high blood pressure. Diuretics are often prescribed first. Beta blockers may be prescribed if other medications aren’t effective and with other drugs designed to lower blood pressure.

Doctors may prescribe these medications for angina, heart attacks, irregular heart rhythm, and migraines. They are often given with other medications.

Beta blockers aren’t usually recommended for people with asthma because it may trigger an attack. It is also not the first choice for people with diabetes because it can mask signs of low blood sugar.

Until more research is done, it is important to discuss medications like beta blockers with your physician and to tell them everything about your medical history to ensure it is the right choice for your health condition.

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