Dr. Scott P. Rose was in his final year of a surgical residency at the University of Florida, on the way to the hospital to make rounds when he learned his brother suffered an overdose.
He doesn’t remember exactly when Steven plunged into his addiction, but he figures it must have been around the time he had his wisdom teeth removed. At first, it was to relieve the pain, but then he needed the prescription medication to get through the day.
“It was incredibly hard to watch,” Rose said. “Addiction affects not only the patient but everyone who is close to them.”
When his wife called that December day in 2006 with the news, it took a while for it all to register.
Steven was just 29 years old. That year, more than 2,000 others also died from drug overdoses.
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Just 10 years later in 2016, there were more than 63,600 overdose deaths in the United States, including 42,249 that involved an opioid. That’s an average of 115 opioid overdose deaths each day.
Experts say opioid addiction is at epidemic levels.
More than 2 million Americans, they say, depend on or abuse street drugs and prescription painkillers like morphine, oxycodone, or hydrocodone prescribed by doctors.
Every day since his brother’s death in 2006, Scott Rose is reminded of this and the responsibility he has to his patients.
It is why Rose, an oral and maxillofacial surgeon, has spent the past decade doing everything within his power to limit opioid pain relief in his practice, which provides a full range of oral surgery from jaw reconstruction to dental implants to wisdom teeth removal.
“Steven’s loss was and continues to be a big influence on how I practice and treat patients,” he said recently.
According to the market research firm IMS Health, doctors dispensed 112 million opioid prescriptions in 1992. By 2012, that number had more than doubled to 282 million.
The good news is that for the fifth year in a row, physicians like Rose have significantly decreased opioid prescriptions nationwide by 22 percent or 55 million.
That was one of the bright spots in a report released in May by the American Medical Association.
“While this progress report shows physician leadership and action to help reverse the epidemic, such progress is tempered by the fact that every day, more than 115 people in the United States die from an opioid-related overdose,” said Dr. Patrice A. Harris, chair of the AMA Opioid Task Force. “What is needed now is a concerted effort to greatly expand access to high-quality care for pain and for substance use disorders. Unless and until we do that, this epidemic will not end.”
Rose and his partners at Northwest Oral & Maxillofacial Surgery are trying to do their part, prescribing opioid painkillers less often.
In January, they set a goal to cut opioid prescriptions by half this year at each of its six locations, which include Marietta and Powder Springs. Doctors are also working to educate the staff about opioid addiction.
“The last thing we would ever want is to see someone become addicted after a surgery that we performed,” Rose said.
Rose said they are developing a continuing education course for dental professionals to be educated about the opioid epidemic and how they can take better care of patients. They also hope to add to their practice a program that would provide patients a way to discard their unused prescriptions.
And here’s the biggie.
It used to be Rose prescribed his patients up to 30 narcotic pain pills after surgery. Now they get about 10.
He attributes the decrease to the growing awareness of opioid addiction and his practice’s decision two years ago to use Exparel prior to surgery.
“I have a discussion with my patients about pain management options, and I inform them about Exparel,” he said. “About 90 percent end up choosing Exparel. Many of them never have to take prescription painkillers and can stick with over-the-counter meds like Tylenol or ibuprofen.”
Exparel is a non-opioid local analgesic that can be administered directly into the surgical site to numb the area on your body where the surgery is being performed.
Rose said the drug is specially formulated to slowly release a proven ingredient — called bupivacaine — over time.
This slow release makes it possible for Exparel to control pain after surgery with just a single dose and can help people use fewer opioids as they start their recovery, he said.
Doctors at Northwest Oral & Maxillofacial Surgery aren’t the only ones who’ve taken note of the epidemic and are taking steps to prevent addiction to painkillers.
For instance, according to the AMA report, health care professionals nationwide accessed state databases more than 300.4 million times in 2017, a 121 percent increase from the year before. Also last year, nearly 550,000 physicians and other health care professionals took continuing medical education classes and training in pain management, substance use disorders and related areas.
The opioid epidemic has created a heightened awareness around the types of medications doctors are prescribing.
As a doctor, Rose feels a responsibility to help lessen the burden by prescribing fewer painkillers and lower dosages.
“I know the pain that addiction can cause an individual and family,” Rose said. “I want to do everything I can to prevent another family from going through what my family had to.”