Individuals who struggle with addiction suffer from psychological, emotional, behavioral, nutritional, and physical issues. They are also prone to a range of severe health conditions like damage to the skin, brain, heart, lungs, liver, and even teeth.
Although many people assume that dental health isn’t as critical as that of heart or other major organs, the link between addiction, dental illness, and life-threatening conditions is undeniable. Oral health issues, especially when left untreated, can lead to other more critical conditions.
A Review of Health Effects and Care by the National Institute of Health indicates that oral health issue is one of the most prevalent addiction-related comorbidities that need more attention by both policymakers and clinicians. Individuals with substance use disorders (SUDs) have more oral health problems than the general population but are less likely to receive care. This is because they spend most of their time intoxicated or trying to find more drugs. Dental visits or personal hygiene are often the least of their worries.
Drugs like heroin, methamphetamine, ecstasy, cocaine, and marijuana can cause teeth and gum problems. In most cases:
Many individuals who abuse drugs have some form of teeth deformity. Even the public health advertisement shows that meth abuse harms the teeth. But like most people, you may not have the slightest idea of how the damage happens, how quickly it occurs, or the type of drugs that affect the teeth. So, here’s a list of common drugs and how each one of them can affect your dental health.
Regular use of opioids and opiates can restrict the production of saliva and dry out oral tissues. Saliva naturally lubricates the mouth and keeps tissues moist. It also clears any leftovers from the gumline and between teeth. Most importantly, it regulates oral acids and bacteria that destroy enamel and cause decay. Again, opioids reduce pain, which makes it hard for users to detect changes in their gums and teeth. Studies reveal that some users apply opioids directly into the gums and teeth to dull dental pain. Unless it gets out of hand, they won’t seek professional help.
Club drugs like MDMA, ecstasy, K2, and molly cause users to grind their teeth, resulting in wear and tear of the enamel. In several studies, 93-99% of club drug users experienced a dry mouth. This dryness can persist for up to 48 hours after use – or even longer after a higher dose. Club drug users turn to soft drinks (which are acidic and sugar-rich) to relieve dry mouth, dehydration, and hyperthermia from vigorous dancing. Add that to reduced saliva secretion and buffering ability, and the rate of tooth enamel erosion will skyrocket. Again, club drug users report vomiting and nausea as a side effect, which could also increase erosion of the teeth.
According to the American Dental Association (ADA), a survey on 571 meth users revealed 96% had cavities, 58% had untreated tooth decay, and 31% had six or more missing teeth. Meth causes serious oral problems commonly described as “meth mouth,” – which presents as extensive gum disease and tooth decay. Once the harm begins, it is near impossible to reverse the effects and, in many cases, results in multiple tooth extractions. What’s more, meth rots teeth very quickly. Meth dries up the saliva, making the teeth more susceptible to decay and cavities. It also causes users to grind their teeth due to stress. Additionally, meth makes one thirsty and leaves them craving for sweet drinks. Sugar feeds bacteria that harm tooth enamel – a process that’s aggravated when there’s no saliva.
Coke users experience an increased rate of tooth decay for a range of reasons: first, the powder is an acidic salt with a low pH (4.5). When applied to the oral or nasal route, it mixes with saliva and raises its acidity levels. This mixture is harmful to enamel as well as the hard dentin tissue underlying the enamel. Secondly, cocaine may cause transient chorea, a movement disorder that manifests in mouth and jaw-related muscle spasms that mimic a strange smile or grinding the teeth. Teeth grinding causes wear and tear and may result in damage to the jaw, surrounding gums, and the enamel.
Smoking cigarettes or marijuana cuts oxygen supply to the bloodstream causing infected gums not to heal. Gum disease is the most common cause of tooth loss in adults. Smoking also leads to dry mouth. Marijuana use is associated with cannabinoid hyperemesis, a condition that causes vomiting. When one vomits regularly, he or she exposes the teeth to stomach acid that causes decay and cavities. Tobacco, on the other hand, can cause bad breath, gum disease, and damage. According to research, smoking may account for about 75% of periodontal disease in adults.
Substance use is detrimental to one’s overall health. If you or a loved one is suffering from drug addiction, it’s best to seek treatment and rehabilitation. Although some dental health concerns like enamel degradation, cancer, and tooth loss cannot be reversed, there’s still plenty that can be done to help restore a healthy mouth and smile. Rehabilitation facilities will also help treat addiction and any co-occurring disorders that contribute to user’s difficulty in maintaining their oral health.
Drug implants like Naltrexone and Buprenorphine are designed to block the effects of opioids for weeks or even months. But, are these drugs more like a magic bullet, or dangerous experiment?
Well, if you or your loved one is struggling with an addiction problem, you likely are trying to find ways to put the issue behind you. After all, drug addiction is a significant concern and has the potential to impact your mental, physical, emotional, and financial wellness.
So, like any other person on the receiving end, you may be open to any treatment as long as it helps you regain control. However, you should be smart in your approach to ensure you make an informed decision.
In this article, we will look at drug implants, how they work, their upsides and downsides, efficacy, FDA approval, and everything else that you need to know about them.
Addiction is a disease that can’t be cured. But it can be managed successfully with abstinence. As we mentioned earlier, addiction can have significant mental and physical impacts. And without quality drug rehabilitation, the problem is likely to progress.
Addiction treatments have evolved widely over the last decades. Traditional programs like the abstinence or 12 Steps are no longer the only options. Today, patients can opt for medical intervention as part of treatment.
This explains why more and more patients are now getting holistic care that sometimes includes MAT (Medically Assisted Treatment) like the Naltrexone or Buprenorphine implant. These treatments are effective in treating opioid and alcohol addiction, helping to reduce and mitigate painful withdrawal symptoms. In addition to blocking the effects of addictive substances on the body, they can prevent relapse and promote abstinence.
Buprenorphine has been the “go-to” option for addressing what has become the worst opioid epidemic in America. According to one study published on Addiction Center, the sale of opioid painkillers increased by 300% since 1999. The study further revealed that about 15 million Americans and 2.1 million Americans have alcohol and opioid use disorder.
Going by these numbers, the situation is alarming.
Probuphine, or “bupe” who’s efficacy placed it on the top spot as “the wonder drug,” binds and blocks the opioid receptors in the brain. So, the patient cannot experience the effects of drugs like hydrocodone, morphine, or heroin. And since the user cannot experience the comfort, euphoria, or pleasure associated with these drugs, he or she won’t have the desire to use them.
Naltrexone is an opioid receptor antagonist that’s used to treat both opioid and alcohol addiction. It disrupts the brain pathways that release dopamine and endorphins (which are the ‘feel-good’ hormones). This drug is often prescribed orally and needs to be taken daily to minimize the symptoms linked to opiate withdrawal and recovery.
Medically assisted treatments are affordable and have shown to help individuals recover from opioid and alcohol disorders, enhance social functioning, minimize fatal overdoses, reduce the risk of transmitting infectious diseases, and reduce criminal activity.
Drug implants are designed to serve the same purpose as their pill and injection counterparts – to treat addiction. The implant blocks opiates for around 2-6 months; a depot injection permitted for medical use in Russia and the US lasts about a month. This prevents the need to take medicine daily, theoretically overcoming the main downside of oral drugs – that individuals often stop taking the tablets and fall back to using the substance.
While one month may not seem like adequate time, it might be an invaluable extension for different interventions suitable to a subset group of patients depending on their circumstances and characteristics – especially those who are prepared to quit using.
Depot injections and implants of Naltrexone are yet to be licensed for medical use in the UK and Australia. Although they can be prescribed, both the doctor and patient must assume responsibility for using the drug, which hasn’t met the efficacy and safety standards involved in licensing.
The United States FDA approves Buprenorphine implant as a treatment of opioid addiction. The medical rods are meant to offer a continuous release of a low dose of the drug over six months. Ideal candidates for implant technology should be clinically stable on other approved buprenorphine treatment systems like films or tablets for at least six months.
Probuphine, a newly approved form of Buprenorphine, is implanted under the skin in the upper arm and removed once the treatment is over. However, most treatment centers include it as part of a holistic treatment plan that’s customized to the patient.
Drug implants offer vast benefits when compared to other dosage forms. For starters, these devices allow the drug to be administered at a specific site where it is most needed. Additionally, the implants allow for a significantly lower dosage of medicines, which can lower potential side effects.
There is also the aspect of sustained-release, which cuts out the risk of drug delivery outside of the therapeutic window. Last but not least, drug implants ensure patient compliance since the regime is generally less daunting than weekly injections or taking pills daily.
One of the significant downsides of implantation drugs is their invasive nature. Since they are placed under the skin, there is a small chance of surgery-related complications. And while unlikely, there is also the risk of device failure and biocompatibility issues.
Drug implants can be effective in minimizing cravings and preventing relapse. Unlike oral medications that come with complications of forgetting or failing to take the daily dose, an implant lasts long and ensures a sustained release.
Although more research is required to substantiate the findings, different studies reveal that drug implants may help stop the addiction. For instance, one study showed that Naltrexone implants, which block opiate-type drugs for months, helped addicts in Norway prevent relapse and overdoses after detox.
Another 2014 systemic review analyzed different study results from nine studies, matching Naltrexone implant to oral Naltrexone or placebo and established that the implants were more effective than both oral Naltrexone and placebo.
Imagine creating the very addictive Oxycontin, an opioid product that people must have. I mean, they need your product so bad that they’re willing to sacrifice their own career, their loved ones, and even life itself to buy what you’re selling. Now distribute this product through a nationwide network of trusted salespeople who also make a great deal of money by selling your product.
Imagine how rich you would be.
That’s exactly what happened to one family in America with their invention of OxyContin.
Opioids have been on the market since 1911 and until the 90’s, the use of these narcotics was limited to very specific circumstances. These powerful pain killers would only be prescribed for end-of-life care or post-surgical pain relief. Everyone within the medical profession understood that these drugs were highly addictive. These drugs were ripe for abuse.
That all changed in 1996.
That was the year the Sackler family who owns Purdue Pharma released a new pain medication called OxyContin – a long-acting form of oxycodone. Purdue Pharma makes other pain killers, but this one was a blockbuster hit. Because of it, the Sacklers became one of the wealthiest families in the US. It was reported that their net worth reached $14 billion in 2015 (yes, that’s a “b” for billions). The wealth was created largely on the strength of profits from OxyContin.
How did they do it?
And better yet, Oxycontin was a long-acting painkiller, they said. This meant the drug was excellent for chronic pain, especially if patients used the twice-daily dosage recommendation.
This was simply not true (as history has shown us). In fact, it was a lie.
The first seeds of the opioid epidemic were planted. Doctors and hospitals began prescribing opioids for long term and chronic pain, and they did so with little or no clinical evidence to back these claims. To make matters worse, Purdue Pharma poured money into the joint Commission on the Accreditation of Healthcare Organizations. They even created a rating system for Doctors and Hospitals that punished or rewarded those for how well they reduced pain in their patients.
Andrew Kolodny, the co-director of the Opioid Policy Research Collaborative at Brandeis University says the pharmaceutical industry financed a “multi-faceted campaign” that “changed the way the medical community thought about opioids and changed the culture of opioid prescribing in the United States.”
You don’t have to look far to see that he is right. The opioid crisis in the U.S. is an “American thing”. It’s uniquely ours. We prescribe opioids to our citizens 40% more than any other developed country.
According to the Centers for Disease Control and Prevention, (CDC) U.S. opioid prescriptions almost quadrupled over a 15-year period.
After the release of Oxycontin, potent narcotics began to flood the U.S. and sales for this highly addictive substance skyrocketed. They go on to report that the number of prescription opioids sold to pharmacies, hospitals and doctors’ offices almost quadrupled from 1999 to 2014. An odd fact since they found no evidence of a change in Americans’ overall reported pain.
Enter the distributors. With such a demand for product, it’s easy to understand how the greedy and unscrupulous jumped into the action. Across the country, pain clinics began to pop-up. These clinics had no real desire to learn if the patient’s pain was real. They were created to simply dispense these pain killers to patients even when there was no legitimate medical reason. It was easy for a clinic to see 50 or 60 patients in a day, charging them anywhere from $200 to $400 for a quick exam and a prescription for their “pain”.
Besides these pill mills, many doctors bear responsibility for failing to do their own research and failing to dig into the bogus claims made by the pharmaceutical industry.
Back to the Sackler family and Purdue Pharma.
The Sacklers appear to be good people. They have a long history of doing good. They donate to civic programs and symphonies so why did the state of Massachusetts sue the Sacklers? Money. It’s that simple. This epidemic has become extremely expensive (link to our cost blog) for all levels of government. In fact, the costs are staggering. Not only does the epidemic come with medical and law enforcement costs, but it has an enormous impact on productivity with 10.3 million Americans abusing the substance.
They need some of this money, too.
Addicts make lousy taxpayers and these costs are becoming a huge burden on our society. Massachusetts was the first to sue the family behind the company, but many states, counties, and cities from all corners of America are lining up to sue Purdue Pharma.
And it’s not just the Sacklers.
The 76-year-old founder of Insys Therapeutics, John Kapoor has recently been sentenced to more than 5 years in prison. The former billionaire aggressively marketed the powerful opioid Subsys and was the first successful prosecution of a pharmaceutical executive tied to the opioid epidemic.
U.S. District Judge Allison Burroughs who sentenced Kapoor said, “This was an offense of greed.”
We are still in the grip of this crisis with the recent wave of overdose deaths from fentanyl, a dangerously powerful and synthetic opioid.
Hundreds of thousands of Americans have died from this epidemic. An epidemic that has put billions of dollars into the pockets of pharmaceutical manufacturers like Purdue Pharma. Their role in this crisis is coming into focus now as more litigations and investigations are directed toward these profiteers. As insurance companies get charged exorbitant amounts of money for shady drug rehab programs, perhaps the true culprits will finally be held accountable.
Emanuel, Gabrielle. Opioid Executive John Kapoor Found Guilty In Landmark Bribery Case May 2, 2019
Center for Disease Control } Opioid Overdose https://www.cdc.gov/drugoverdose/data/prescribing.html
Affairs (ASPA), Assistant Secretary of Public (December 4, 2017). “What is the U.S. Opioid Epidemic?”. HHS.gov. Retrieved December 16, 2019.
Scholl L, Seth P, Kariisa M, Wilson N, Baldwin G. Drug and Opioid-Involved Overdose Deaths – United States, 2013-2017. WR Morb Mortal Wkly Rep.
Kolodny et al. 2015. The prescription opioid and heroin crisis: A public health approach to an epidemic of addictionexternal icon. Annual Review of Public Health 2015 (36); 559-74.
The price of heroin in California is more than you can afford. In fact, it’s more than you should afford. Although a 2018 study by the National Drug Early Warning System (NDEWS) found that heroin use in the Los Angeles area was lower than the national rate, heroin treatment admissions were still at a dangerously high level.
The US National Library of Medicine used literature based estimates to create a model for the actual monetary cost for the abuse of heroin. They estimate that it costs US taxpayers $51 billion dollars a year – or $50,799 per heroin user.
That’s a lot of money.
And it’s getting worse:
Widespread availability and the contributing use of opioids has doubled the number of heroin users every decade. While the epidemic is obliterating communities and towns throughout the US in astonishing numbers, we forget to remember how devastating the use of heroin can be to just one person.
Heroin’s effects on the brain and nervous are notorious. Its ability to erase any other source of reward or gratification can cause addiction quickly. Sometimes in as little time as two weeks. Combined with heroin’s brutal withdrawal symptoms, the user’s life can quickly spiral out of control. On average you will spend $150 a day or more to support your habit, but there are even greater costs. The price you will pay for an addiction to heroin will impact your work, your life, your relationships, and your health.
Heroin erodes your ability to sustain any honest or responsible behavior with your loved ones. Your marriage, your friendship, even your relationship with your family will break down as the desire to get high from heroin begins to supersede anything else in your life. Heroin will corrupt the way you perceive happiness and joy, at the expense of everyone around you.
Your heroin use will even result in the loss of your child custody rights if children are involved. No court in the country will allow your heroin use to come before the health of your child and they will be taken away from you.
If your company drug tests its employees, you will lose your job. If you’re seeking employment, you will have to pass a drug test during the hiring process. Your use of heroin will most certainly jeopardize your ability to secure employment. If you begin to use while you’re employed, the heroin or other opiate use will lead to mood swings, reduced motor skills and an overall reduction in productivity. Soon, your absences will begin to pile up. Habitual tardiness becomes the norm and discipline problems hit your record. The next thing you know, you’re fired.
It’s almost cliché how drug habits will drain your bank account. When you can only think about getting your next high, saving money for rent, food, bills, child care, or anything else quickly becomes irrelevant. Your habit becomes more expensive and eventually unstainable.
Ask an addict to describe the lowest point of their addiction and I will guarantee you that they tell you the story about the first time they were incarcerated for stealing to sustain their habit. It’s inevitable that you will need to find money to sustain your heroin addiction as you constantly try to achieve that narcotic bliss of your first exposure. Chasing the dragon, as they say. This will lead to lying, stealing, and eventually the loss of your freedoms with eventual jail time.
It may be easy to point to the devastating effects of heroin addiction on an individual, but we can’t ignore the cost to our society as a whole. Where does that $51 billion dollars come from? The University of Chicago studied the financial impact of heroin and found the following repercussions
Whenever a crime is committed, our society is forced to pick up the tab. These costs include:
When your habit begins to affect your work, your ability to provide for yourself and your family becomes diminished, as well as your ability to contribute to society in a positive manner. These costs include:
Heroin destroys your body and its ability to function properly. You will soon find yourself seeking medical attention and paying for things like:
In addition, you can’t pay for healthcare because you lost your job and spend all your savings on your habit, then society must pick up the tab for:
It’s impossible to calculate the cost to a child growing up in an addictive household. Engaging in risky and illegal behavior puts your children at risk and creates an environment that increases the chances that they will follow in your footsteps.
It may be obvious to most that heroin and other opioids are truly devastating for an individual as well as a community. When you add up the above costs, as well as what the typical users spend on his or her habit, the number is staggering.
But it doesn’t have to be this way.
No one can tell you that getting clean is easy, but they should tell you that it is imperative – for you and everyone around. If you are starting to feel your life beginning to spiral downward for heroin use, or any drug for that matter, reach out for help.
Ask for help.