The US is the only place in the world AFAIK where you will get prescribed opioids for something as trivial as a wisdom tooth extraction (kind of like one of the cases cited). It is also the only place in the world AFAIK going through the opioid epidemic.
Every other country in the world has got the problem of painkillers figured out. So it can't be that complicated.
Objectively, opioids are prescribed much less often outside the US.
Subjectively, I got four wisdom teeth extracted in two sessions of two extractions each. Both times I only needed generic acetaminophen to manage the pain.
Perhaps an US surgeon have insisted on doing it all in one session, in which case I would have found the pain and discomfort intolerable and opioids would have made more sense.
In any case, they should probably figure out why their patients are in more pain than the patients of foreign surgeons and fix that. It could be something silly like them being less gentle during surgery because they are used to their patients being on opioids.
Don't have any sources available, but as an European it's strange how prevalent opioids are in the States for what are seen as "regular" medical interventions. I remember having a discussion with a US redditor, telling him/her that even though I had 3 or 4 teeth extracted during the last 10 or so years I've never been prescribed opioids (the extractions were done by different doctors, in different clinics), I've always managed the post-extraction pains with Nurofen-like drugs and I was quite ok (and I don't think of myself as a particular "pain-resistant" guy, quite the contrary). There were other redditors in the same thread (I remember one from Germany) who had had the same experiences as me. So, all things considered, these numbers don't surprise me at all.
I mentioned this elsewhere, but I had wisdom teeth out recently, and took ibuprofen and nothing else (they did give me a prescription for a heavier-duty NSAID, but from past experience those are no fun). It was _fine_, there was some pain, but that’s par for the course.
Opiods seem to be treated as almost essential for dental surgery in the US, and as a rare escalation path elsewhere.
As a non-American I'm also curious about the mass necessity of opioid painkillers to begin with. From what I hear, people are prescribed opioids post surgery etc. which is bonkers to me as a foreigner. I'm a middle aged person and I have never seen anyone using opioid painkillers anywhere in my life. They give stuff to you when you are having surgery, and when you are in hospital's care, but something very extraordinary has to happen here to have access to those medications outside of a hospital setting. In the USA it seems to me like most people are prescribed these painkillers at least once in their life between 1-50 years but here, it is very exceptional and people are doing just fine.
I'm honestly shocked how American doctors seem to give out opioid prescriptions for any illness or pain. I've not once heard from somebody here (Germany) that was prescribed opioids by their dentist after a surgery. They usually tell you to take some tylenol and rest at home, I've never heard of somebody getting opioid for that. But I've heard it mentioned multiple times regarding american dentists.
There surely are more examples where the docs seem to be a lot less careful about giving out these drugs. Also I think, and that's not only regarding the US, but all of the world, people should be getting way more education about what these drugs are, what they cause, how they should be taken and how you should stop taking them / what risks it bears if you don't.
Interesting. I wonder if we have stats on painkiller usage per country? I found this ranking of countries by Opiate usage[0] which places the US at 27 (below Ireland, Switzerland, Italy, and the UK.
Maybe I only hang out with granola Americans, but the only people I know who think the way you describe-- looking for pills to solve minor problems-- are relatives of medical personnel.
I can't think of the last time I personally took a pain killer. I didn't even take one after a major surgery I had a couple of years ago.
Not really. I am surprised at the ridiculous hoops Americans have to go through to get controlled drugs from the pharmacy. Photo ID, special prescription pads for the doctor, a special copy filed off with the federal government... here we just pick up the prescription. As far as I can tell the difference is doctors are just less willing to prescribe opiates here for minor or transitory pain. I've always gotten Tylenol after dental surgery for example. I groan about it but it probably hurts less than a smack addiction would.
Off topic, but it's insane to me, people in the US get opioids for small surgeries. Here in Germany I had a motorcycle accident resulting in multiple (around 12) face fractures and later I had to get an incredibly painful eye surgery and both times I was given large doses of ibuprofen for the pain (which didn't do much).
At the time I wished for better painkillers, but maybe it's actually better that way...
Move to Europe where we don't get as many drugs prescribed? I think the only time you get opioids is after major surgery. Personally I don't know anybody who had to take them.
When I was living in Europe and had my wisdom-tooth removed I only got a local anesthetic so I wouldn't feel the cutting. Recently I heard a friend of mine (here in the US) say she was given vicodin afterwards. To me that's just insane. Sure I was a little uncomfortable for half a day but I'm not going to take bloody opioids because of that. It might also be the case that people just don't ask for it as easily as in the US (I mean, it's much more common to hear Americas place food orders with a bunch of custom stuff, Europeans usually just order what's on the menu).
How does the prescription rate in the US compare to other countries? When growing up in Germany i never heard of opioids being prescribed besides maybe cancer patients. But in the US I was always given plenty of opioids for even pretty small problems. A while ago I had to get really serious with my girlfriend after only two weeks of them because she already couldn’t handle the withdrawal.
In Croatia you have to be very much in pain to be prescribed opioids. The strongest pain killer i got is Voltaren, for toothache. A friend got opium, or some derivative of, when he got chopped up because of cancer (same goes for other major surgeries).
We have good, state employed, doctors.
I have seen some heavier drugs prescribed by shrinks, but i don't know how (physically) addictive they are.
If you ask me, the whole USA medical thing is broken by design.
I think this is definitely the problem in the United States. In my country they don't just willy nilly prescribe opioids. The best you get is ibuprofen. For example, after a terrible shoulder injury or tooth extraction, that's all you get. It helps with the pain, but doesn't remove it 100%, doesn't get you hooked though. Of course they give IV opioids after surgeries and such, but even then something mild and in small doses, and only for a certain period time. I remember still feeling pain after an appendectomy, but they refused to give me any more tramadol and just switched to IV ibuprofen. It's just not a thing as a prescription medicine. Except maybe for terminal cancer patients or something equally drastic.
Going off on a tangent, what my country might have a problem with, is benzos, however. They're prescribed like psychiatric vitamins.
The US loves to sedate. You guys get absolutely blasted when you have your wisdom teeth removed. In most of Europe you get strong pill painkillers for the first few days and then it’s paracetamol.
Hmm... this is contrary to my experience (US). For every single thing that was a surgery (including tooth extractions) in the past decade, I got a shitload of opioid painkillers just by default. At least 30 pills for each intervention.
I believe I was lucky because after the first surgery I had, the doctor gave me the prescription, but off the record told me that he's doing that only because of hospital protocol and I should not take the pills. He told me to my face to not fill the prescription. Because of that (which was my first run-in with pain management) I never touched opioids. In my experience, the worst offenders have been the dentists. Now I do believe there are legitimate uses for this type of medication but honestly prescribing me 20-30 vicodins for a tooth extraction is a bit overkill.
Every other country in the world has got the problem of painkillers figured out. So it can't be that complicated.
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