Surgery/wisdom teeth removal while on Heroin???

I need to have my wisdom teeth removed, have a plate and 5 screws removed from my hand, and have a pilonidal cyst removed. The latter I'm not positive I want to do yet since there's basically a more than 50% chance it will just keep coming back anyways.

However, the hand and teeth I definitely need to have done. For both I would request to be knocked out. I've been doing opiates for about 4.5 years now and boy for about 3.5. I had the surgery on my hand done when I was doing boy, but I wasn't doing as much as I do nowadays. I do at LEAST a gram or two a day now and have been doing that for a solid 1.5 years or more. My concern and question is: would having that amount in my system cause any complications with the anesthesia (i.e. not wake up )? Or another concern is having such a high tolerance that the pain medicine they give me during surgery wouldn't be effective.

The only reason I've put it off up to this point is because of these concerns.

Any help would be appreciated.

I'm guessing boy is heroin eh?

You'll just have to tell your surgeon or speak with your anesthesiologist beforehand so they have an idea of what you are going to need. I have a feeling your dentist might not feel comfortable putting you under for wisdom teeth extraction if they don't think they are experienced enough to deal with it and is something you'll want to bring up with them first. They might refer you to an oral surgeon or something.

I think this question will do better over in Healthy Living as it is more of a doctor questions and not so much about drugs.

OD >>> HL

amapola said:

I'm guessing boy is heroin eh?

You'll just have to tell your surgeon or speak with your anesthesiologist beforehand so they have an idea of what you are going to need. I have a feeling your dentist might not feel comfortable putting you under for wisdom teeth extraction if they don't think they are experienced enough to deal with it and is something you'll want to bring up with them first. They might refer you to an oral surgeon or something.

I think this question will do better over in Healthy Living as it is more of a doctor questions and not so much about drugs.

OD >>> HL

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Yes, boy is heroin. And its an oral surgeon doing wisdom teeth extraction obviously. The reason I ask these questions here is because I don't want to tell my doctors what I do in my private time. I don't want something going on my medical record and affecting me getting health or life insurance in the future.

It's not at all obvious that an oral surgeon is doing your wisdom teeth extraction. I still have mine but my ex-girlfriend had her dentist take them out and at the time I think the stat I heard was 75% of cases are referred to an oral surgeon based on the level of complication and dentist's own experience and confidence.

Anyways if you don't tell anyone about your tolerance to opioids then you'll risk being under medicated. I remember reading about somebody who just told their anesthesiologist while going into surgery and it worked out for them, but I think you would risk them not having the right equipment on hand or something. I'm really not sure so I suppose I'll let someone who has had personal experience in the matter respond. I honestly can't imagine not saying anything at all though and think you'd be better off mentioning you have a tolerance and just not saying how you got it. Leave it at that.

amapola said:

It's not at all obvious that an oral surgeon is doing your wisdom teeth extraction. I still have mine but my ex-girlfriend had her dentist take them out and at the time I think the stat I heard was 75% of cases are referred to an oral surgeon based on the level of complication and dentist's own experience and confidence.

Anyways if you don't tell anyone about your tolerance to opioids then you'll risk being under medicated. I remember reading about somebody who just told their anesthesiologist while going into surgery and it worked out for them, but I think you would risk them not having the right equipment on hand or something. I'm really not sure so I suppose I'll let someone who has had personal experience in the matter respond. I honestly can't imagine not saying anything at all though and think you'd be better off mentioning you have a tolerance and just not saying how you got it. Leave it at that.

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I didn't mean anything by saying it was "obvious" an oral surgeon was doing it; I just assumed they are the ones who always do it. And yeah I suppose I could just tell the anesthesiologist beforehand; I guess I could just say I am on painkillers for some reason or another.

Anyone else with experience in these matters I would greatly appreciate your feedback.

Hey, yeah I recently had an oral surgeon extract two of my wisdom teeth and was put under for the procedure as this is this particular doctors way of performing this procedure. I was on a high (500mg) dose of oxy when I went in, so I asked what meds would be used to knock me out, I also did some research on what is typically done. For the most part, if one is put under, the oral surgeon will use IV midazolam (benzo) alone, OR combine the midazolam with IV fentanyl. I asked and he said just Midazolam, so I didn't say anything as my opiate tolerance is very high and everything was fine. Go in with just enough heroin in you to be well (I.e. Not in w/d nor nodding in and out) , ask what will be used, and if any type of opiate will be administered, THEN say you took a few percosets before coming in or something and see what he says...if ur only getting an IV benzo, u should be fine, but since death is a possible outcome, play it safe and tell him u took some painkillers b4 and is it ok to still be put under. Better safe than sorry, and u don't have to say heroin, just say u took some Rx opiates u had laying around the house, and if u don't wanna admit that, then please please please just use enough dope to keep the w/d away to minimize the danger

Be honest with your surgeon and anesthesiologist, because midazolam is versed which can potentiate the effects of the opiates already coursing though your system. Therefore increasing its effect on your respiratory drive and maybe even stop you from breathing and in a environment like a dental office with not mechanical ventilation that can be extremely dangerous.

hmm ive had dental work under h, maybe general anesthesia is different to local regarding whether you will wake up or not.

No its prolly a bad idea to do heroin if their putting you out.. just tell them about your tolerence and they should adjust your pain meds to compensate.. maybe have some heroin ready at home as they'd be less likely to send you home with meds if you tell them about your drug use..

I'd think it's not worth dying to not tell your doctor/dentist you're on heroin. They can't do anything about it anyways.

Don't be high when you go in, or they might OD you. But unless your tolerance is crazy crazy high then you should be ok(I've had a couple surgeries with a 300mg OC tolerance) just didn't use more than 30mg for 24+ hours before hand. I was a little worried that they wouldn't be able to keep me under or something lol(one time I know they were using fent, not sure the other time) but it went fine.

I never told them about it because I was afraid they wouldn't give my any pain meds afterwards.
But if you want to risk it, they are either going to give you more, or not give you any.

updated answer from 2014

Just as an updated answer to this very important question. I went on 10/27/14 to get 5 teeth removed. 4 wisdom and 1 molar. I didn't say anything to my dentist but did decide to tell the anesthesiologist right before surgery. He told me that he was only using Midazomal (benzo, the most usual anesthesia they use) and therefore, it could slow down my breathing but that he has had other patients addicted to opiates before and they did just fine. My surgery went great and I was knocked out the entire time and I used right before I went to my appointment. Lesson I learned was always be truthful before surgeries and you'll be just fine! Hope this helps!

Oh. I've been using opiates for 7 years, boy for 2 and IV for about 6 months. Hope this helps!

Well that's good to hear. I was worried that the drugs to put me under wouldn't be powerful enough and I'd wake up halfway through or something. I guess I'll have to tell the dentist anyway although it sucks revealing secrets.