US Pharm. 2019;44(3):33-35.

Opioid painkillers prescribed for wisdom teeth surgery could steer teens and young adults on a path to long-term opioid use, a study finds. According to researchers from the University of Michigan (U-M), young people aged 13 to 30 years who filled an opioid prescription immediately before or after they had their wisdom teeth out were nearly 2.7 times as likely as their peers to still be filling opioid prescriptions weeks or months later.

The study, published in a research letter in JAMA, reported that those in their late teens and twenties had the highest odds of persistent opioid use, compared with those of middle school and high school age. Led by Calista Harbaugh, MD, a U-M research fellow and surgical resident, the investigators relied on insurance data to analyze young people who were opioid naive—individuals who had not had an opioid prescription in the 6  months before their wisdom teeth extraction and who did not have other procedures necessitating anesthesia in the following year.

“Wisdom tooth extraction is performed 3.5 million times a year in the United States, and many dentists routinely prescribe opioids in case patients need it for post-procedure pain,” says Harbaugh, a National Clinician Scholar at the U-M Institute for Healthcare Policy and Innovation. “Until now, we haven’t had data on the long-term risks of opioid use after wisdom tooth extraction. We now see that a sizable number go on to fill opioid prescriptions long after we would expect they would need for recovery, and the main predictor of persistent use is whether or not they fill that initial prescription.”

Several other factors predicted risk of long-term opioid use. Teens and young adults who had a history of mental health issues, such as depression and anxiety, or chronic pain conditions were more prone to progress to persistent use after filling their initial wisdom tooth–related prescription.