ROSEMONT, Ill., Sept. 9 /PRNewswire/ -- Substance abusers who think it’s okay not to tell their oral and maxillofacial surgeon about their drug use are putting themselves at risk for surgical complications, even if they’re having a procedure as relatively straightforward as a wisdom tooth extraction. “Illicit drugs and anesthesia can mix in some potentially hazardous ways,” says Sue Carlisle, PhD, MD, chief of anesthesia and perioperative care at San Francisco General Hospital, who will speak at the American Association of Oral and Maxillofacial Surgeons Annual Meeting, Scientific Sessions & Exhibition, September 29 - October 2, in San Francisco, California.
“Since few abusers of controlled substances readily admit drug use to their doctors, it’s important for OMSs to recognize the signs and symptoms of drug abuse and be prepared to intervene,” says Dr. Carlisle, whose symposium is entitled “Street Drugs and the Oral and Maxillofacial Surgery Office.”
Those signs and symptoms can include unusual changes in blood pressure or heart rate, unexpected flushing of the skin and exaggerated reactions to anesthetic drugs.
“Practitioners need to be aware of the physiologic interactions of controlled substances with anesthetics, because substance abuse is so common in the population,” she says. According to the 2002 National Survey on Drug Use and Health, an estimated 22.0 million Americans were classified with substance dependence or abuse -- 9.4 percent of the total population aged 12 or older. Of these, 3.2 million were classified with dependence on or abuse of both alcohol and illicit drugs, 3.9 million were dependent on or abused illicit drugs but not alcohol, and 14.9 million were dependent on or abused alcohol but not illicit drugs.
Narcotics, for example, can exaggerate the effects of sedatives given before surgery, leading to excessive drowsiness or unconsciousness, notes Dr. Carlisle. Clues to a patient’s drug use include an exaggerated response to a narcotic given by the OMS; extreme agitation, which may manifest itself as aggressive behavior; and abnormal pupil size, too large or too small.
In addition, chronic users of alcohol may exhibit extreme responses to anesthetic agents, depending on the condition of their liver. If the OMS knows the patient has a history of alcohol abuse, potential problems may be avoided by treatment modification.
Because patients are hesitant to report drug abuse to doctors, Dr. Carlisle advised OMSs to elicit information by beginning with non-threatening questions such as “Do you smoke?” and “How much alcohol do you drink?” eventually leading up to “Do you use any non-prescription drugs or street drugs?” “If you work up to it gradually, patients will usually tell the truth,” she says.
The American Association of Oral and Maxillofacial Surgeons (AAOMS), the professional organization representing more than 7,000 oral and maxillofacial surgeons in the United States, supports its members’ ability to practice their specialty through education, research, and advocacy. AAOMS members comply with rigorous continuing education requirements and submit to periodic office examinations, ensuring the public that all office procedures and personnel meet stringent national standards.
American Association of Oral and Maxillofacial Surgeons
CONTACT: Marquita M. Hynes, Senior Communications Associate of AmericanAssociation of Oral and Maxillofacial Surgeons, +1-847-678-6200, or fax,+1-847-678-6286
Web site: http://www.aaoms.org/
