Opioids Emergency - Dentists & Opioids

[DesertHarp]

Hi. I am freaking out because I have to have dental surgery this week. My big worry is - can the dentist or dental surgeon order me some additional opioids, when I already get Vicodin from my primary care doctor?

I legally get Vicodin 10mg/325mg (hydrocodone with acetaminophen.) 60 tablets per month for back pain. I take a tablet twice daily. It's a challenge to ration them out, so I don't withdraw, by running out before a refill is due. Been there, done that. Extreme restless leg syndrome that was torture.

I just saw online that the short answer is - No. So does that mean, I'm supposed to not have additional pain relief for this ordeal ahead of me? I've become so habituated to what I take daily that it does a lot less for me than it used to do.

I thought, maybe, I could ask my pcp doctor to allow me additional tabs, just to get through this. However, I don't believe your doctor can treat pain that is due to a condition being managed by another provider, such as a dentist.

Does anyone know what's involved in getting opioid pain pills from 2 different providers/prescribers. It must happen occasionally.

 

[WellTram]

According to my experience ( EU ) , ONLY one doctor vám prescribe me opioids and it Is my algeziologist. When i need additional pain relief, i have to contact her - no other doc will prescribe me anything.

But u have more options.
Sometimes i boost my pain relief by using diclofenac, naproxen or ibuprofen with my tramadol + paracetamol or dihzdrokodein.

I am not sure if u have this in your country but metamizole is quite potent and absolutely not addiction pain medication.
Also , dextrometorfan is great for pain. They should long time ago give it to people not only to stop cough but also pain. But it's trippy with even low doses so maybe they rather marketed tramadol, tapentadol for pain. But i also experienced hallucinations from tapentadol...

Asi for tizanidine, it Is short acting but very good for pain.

Use your hydrocodone + paracetamol and add NSAID + tizanidine. U will be fine.

 

[DesertHarp]

I can't use NSAIDS because I have a recurring stomach ulcer that bleeds now and then. I was prescribed tizanidine in the past for chronic aches, but it was not helpful. I won't be fine, but thanks for the optimistic forecast.

I'm in the U.S.

7:30 a.m. Have been awake all night. I feel wretched.

 

[Keif' Richards]

This is going to be different in every scenario. The answer largely depends upon the discretion of the prescriber(s). Doing this "legitimately" would mean everybody in your care team being fully aware of the situation. With this in mind, your current Opioid prescriber would almost certainly take the lead regarding any Opioids prescribed.

In this climate, meaning we are in extremely conservative times regarding Opioids, it would be unlikely to get any kind of additional prescription. If your doctor is well-known to you and trusts you, then it is not crazy to think he could allow you to take a few extra for 2-3 days and then pick up your next script early. That would be completely up to them.

From a purely ethical standpoint, it is not a good decision to risk the long-term benefit of your pain medications on a situation that lasts only a few days.

You speak of your tolerance. The truth is, even if a patient is 100% compliant, Opioids are extremely difficult to use for long-periods of time while retaining their efficacy. Literally every single extra tablet a person takes has ripples that will travel through the course of their entire life. The equilibrium is so much more delicate than most people understand.

Taking extra tablets for a few days will likely lead to a less-effective analgesia for several days following this increase. This is the type of tide/back and forth that can lead to a complete derailing of a person with their pain medications. For someone who is totally reliant on Opioids for their quality of life, it is a huge risk to provide more medication for a condition that will only last a few days.

I share this opinion dude. I would recommend against increasing the dosage of your Opioids. If you have pain from this surgery, MAYBE have an extra dose of Opioids for the first night to help you get to sleep, but that's it. Messing around with something as seemingly innocuous as this is a big risk for something you're capable of getting through on your own.

To answer your question, if you're going through this legitimately and honestly, the issue is totally up to your original prescriber. If you want my advice, do not mess with your Opioids for this. You may need pain relief for something much worse in the future.

 

[DesertHarp]

This is going to be different in every scenario. The answer largely depends upon the discretion of the prescriber(s). Doing this "legitimately" would mean everybody in your care team being fully aware of the situation. With this in mind, your current Opioid prescriber would almost certainly take the lead regarding any Opioids prescribed.

In this climate, meaning we are in extremely conservative times regarding Opioids, it would be unlikely to get any kind of additional prescription. If your doctor is well-known to you and trusts you, then it is not crazy to think he could allow you to take a few extra for 2-3 days and then pick up your next script early. That would be completely up to them.

From a purely ethical standpoint, it is not a good decision to risk the long-term benefit of your pain medications on a situation that lasts only a few days.

You speak of your tolerance. The truth is, even if a patient is 100% compliant, Opioids are extremely difficult to use for long-periods of time while retaining their efficacy. Literally every single extra tablet a person takes has ripples that will travel through the course of their entire life. The equilibrium is so much more delicate than most people understand.

Taking extra tablets for a few days will likely lead to a less-effective analgesia for several days following this increase. This is the type of tide/back and forth that can lead to a complete derailing of a person with their pain medications. For someone who is totally reliant on Opioids for their quality of life, it is a huge risk to provide more medication for a condition that will only last a few days.

I share this opinion dude. I would recommend against increasing the dosage of your Opioids. If you have pain from this surgery, MAYBE have an extra dose of Opioids for the first night to help you get to sleep, but that's it. Messing around with something as seemingly innocuous as this is a big risk for something you're capable of getting through on your own.

To answer your question, if you're going through this legitimately and honestly, the issue is totally up to your original prescriber. If you want my advice, do not mess with your Opioids for this. You may need pain relief for something much worse in the future.

I read this post a few times. You make important points. I am pondering them.

I take all you said above to heart, and I suspect you're giving me sensible advice, I'ld do well to heed.

 

[DesertHarp]

I went to a new dentist yesterday. He seemed to get real cold, when I asked about what he could prescribe for pain. He saw that I already take Vicodin twice daily. He seemed to think that was enough stuff to be on. I believe he was very competent and came to a well-thought out recommendation for what needs to be done about my tooth. But I hated the way he was looking at me when I brought up the issue of opioid analgesia. His facial expression went icy. His tone of voice got very measured. I wondered if he thought I was using my toothache as a pretence for getting ahold of more opioid.

I'm old enough to remember when there was no problem getting opioid pain meds from a dentist. Once I had a dental abscess, and was prescribed Vicodin. I feel like pain control is a right. Well, I can think anything I damn well please, but things are the way they are, and that's that.

The dentist said that, if I went to an oral surgeon, they have a little more latitude to prescribe. Even those specialists are going to have some qualms when they see that I'm already on an opioid.

Anxiety was driving me crazy, and I still didn't get my shipment of cannabis gummies. So I went to a cannabis store and bought $60 worth of edible weed. I hadn't slept in over 24 hours. 4 gummies had knocked me out. That eased the anxiety. 3 hours ago, I had a Vicodin. Now, thanks to those two substances I'm having some peace of mind. Whenever I take a Vicodin, I get quite an easing of mental distress. I actually feel pretty good right now.

 

[TessaBella]

Hi. I am freaking out because I have to have dental surgery this week. My big worry is - can the dentist or dental surgeon order me some additional opioids, when I already get Vicodin from my primary care doctor?

I legally get Vicodin 10mg/325mg (hydrocodone with acetaminophen.) 60 tablets per month for back pain. I take a tablet twice daily. It's a challenge to ration them out, so I don't withdraw, by running out before a refill is due. Been there, done that. Extreme restless leg syndrome that was torture.

I just saw online that the short answer is - No. So does that mean, I'm supposed to not have additional pain relief for this ordeal ahead of me? I've become so habituated to what I take daily that it does a lot less for me than it used to do.

I thought, maybe, I could ask my pcp doctor to allow me additional tabs, just to get through this. However, I don't believe your doctor can treat pain that is due to a condition being managed by another provider, such as a dentist.

Does anyone know what's involved in getting opioid pain pills from 2 different providers/prescribers. It must happen occasionally.

My doctor says that they have to check the national database to see if the patient recvd opioids from any other doctor or dentist. Depending On The doctor this is grounds to immediately stop your prescription. They don't care about an extra need like dental work.

 

[ChickenScratch]

I had to get a wisdom tooth yanked the other day. They were going to prescribe me tramadol, I asked for something stronger, they gave me tylenol 3. I was bummed but it actually helped and the pain wasn’t nearly as bad as I had expected. Hope the same for you.

 

[evo4ever]

I've had a few molar teeth pulled out in the past and I've never needed opioids.

 

[thurston]

If you think you'll need extra then you should probably only take 1 1/2 for a few days before and save some up.

 

[DesertHarp]

Thanks for the replies above. I found a dentist who does believe in adequate pain control. She pulled the tooth and ordered me 12 Percocet, even knowing that I was already on Vicodin. That shows how much dentists can differ in what they'll do for you. So I'm glad I shopped around. (She was the 4rth dentist I saw over this one tooth.) It turned out that the extraction was easy, and I didn't have all that much pain after.

I do appreciate the advice on saving up tablets out of my regular supply for a time of need. However, I'ld had such a bad toothache that I was already low from medicating it. It was a second molar. Anyway, it went well. Thanks for the moral support.