Norco prescription for wisdom teeth?

Given the national opioid crisis, I was shocked that my 17 year old came home from the consult with the oral surgeon for his wisdom teeth removal with a prescription for 20 pills of Norco 5/325 (along with a prescription for ibuprofen 600 mg).  My RN sister says "Norco is hydrocodone and acetaminophen, hydrocodone is a lot stronger than codeine" - it's a Schedule II drug that has to be written on special prescription pads to deter copying/misuse.

I had my wisdom teeth out later in life and took one dose of the stronger pain medicine then was fine with ibuprofen after that.  I asked around and other teens seem to have had the same experience lately - prescribed 20 norco pills, took 2 or 4 max.  Does this match your experience?

I am not concerned about my teen misusing this opioid, but instead I'm concerned about it falling into the hands of others who may intentionally abuse it or inadvertently be harmed. I'm shocked the oral surgeon would prescribe so many more than are likely to be needed given the situation we're in with opioids and the potential for abuse in this age group.  I plan to call the office and voice my concern, but was curious to hear what others think, both about how many pills of norco are typical to need after wisdom teeth removal, and about the risks of over prescribing.

My pediatrician sister and my RN sister both suggest not filling the norco and just going with ibuprofen, holding the norco "just in case"  - which is exactly the opposite of what the surgeon instructed ("fill it before you come to the procedure").  The other option I'm considering is having the pharmacist just fill it for 2 or maybe 4 pills, so there are less lying around after.  Even aside from abuse, it's a pain to dispose of schedule II drugs properly.  You would think oral surgeons would be helping us out here by not over prescribing, right? Apparently not...

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The surgeon prescribes the Norco because some patients really do need it.  It’s almost impossible to know in advance who will need Norco and who will be fine with ibuprofen only.   My husband didn’t need anything stronger than ibuprofen when he had his wisdom teeth removed, but I needed the whole prescription.  My son needed all of his Codein after having his adenoids removed.

The WHO considers pain relief to be a human right.   If a doctor doesn’t prescribe effective pain management, they can be successfully sued.  My pediatrician told me a case about a Marin oncologist that was successfully sued by the family members of a patient that was in extreme pain even though the patient was receiving the maximum amount of pain relievers due to tightened criteria to prevent abuse (but still well below max doses of the medication that would cause respiratory failure).  Mandating maximum dosages of pain medication puts doctors in a very difficult position, as it means that they can’t treat individuals with varying levels of pain effectively.  Providing adequate pain relief is a main tenet of medicine.

The advice from your family members in the medical profession is curious.  If one waits to take analgesics or pain meds until the pain gets bad, then it takes a lot more pain medication to get the pain under control.  The medical community regularly advises not to wait until pain becomes severe to take pain medication.  Pain is easier to control when it is mild.  This is why a doctor will provide a pain medication script before surgery, as it will allow a patient to have access to pain medication quickly if it is needed.  

It is your choice whether to fill the prescription in advance or whether to fill it for a lower amount of pills.  Your medical professional family members probably don’t have any issue filling prescriptions quickly, and wouldn’t see a downside to filling the prescription at a moment’s notice.  Personally, I have had to wait 2-3 days to get schedule 2 drugs filled for my son because the drugstores don’t keep a lot of the medications on hand in the store and have to order the pills from a distribution center.  I fill prescriptions in advance now, because of the potential for delays.

If you are concerned about how to dispose of unused Narco, then call the surgeon to see if they will dispose of the unused pills or talk to the pharmacy.

Calling the surgeon to complain about the prescription for pain medication is completely inappropriate.  Take care of your own business, and don’t try to tell others what they do or don’t need.  You have no idea of what other people need.

Hi, there. My then 16 year old had her wisdom teeth (all 4, impacted, and really wedged in there) extracted last Spring. They prescribed Norco for her: 24 tablets. Having had two of my own wisdom teeth (fully emerged, and worn out) extracted as an adult, with no need of any drugs, I was expecting her to have a similar experience. I filled the prescription just in case. Here was our experience: she was in real pain for most of the week. She requested, and I gave her, the Norco. Your query caused me to go and count the remaining pills which I have stashed in a safe spot; she used 14 out of the 24. It turns out there's a reason why they prescribe it; that my experience was completely different from hers. I recommend that you fill the prescription, administer the pills yourself, writing down the times you've given them, and think about a very safe stash place for any leftovers. You could also request a smaller amount, but I'd say ask for at least a dozen.

Our daughter, also 17, had all 4 of her wisdom teeth taken out in a single surgery.  She was only prescribed iboprophen (600mg) -- no Norco.  She was in a lot of pain, even though she is very tough.  We called the doctor's office over the weekend she was in so much pain.  By the way, days 3 and 4 are often the worse for pain (not days 1 and 2) for wisdom teeth removal, which we found out on that weekend phone call.  If they had prescribed Norco pills, they would have been helpful on days 3 and 4.  Daughter was in pain for almost a week.  

For other folks wisdom teeth removal has been more routine (including me), so the need for pain killers took my by surprise.  But having all 4 done at once and the way the teeth were variously positioned made it a significantly worse.  I can see a surgeon going either way with the Norco.

Ordering a few Norco pills as an option, and controlling their storage and use as a parent, seems fine to us.  In fact, my partner has a stronger Norco precription (7/325) for chronic pain and uses it a few times a month as needed for severe pain -- for years now.  No increase in use, no addictive behaviors.  Taking Norco pills 1-2x after a surgical procedure isn't going to cause an addiction or a dealer to blossom.  (Don't get me started on oxycotin though...)

He'll be ok whatever you decide, and good luck to both of you!

I have been prescribed opioids after the five or six surgeries I've had, and seldom use more than a couple of pills. I had many old bottles in the bathroom, dating back to the C-section births of my kids. My kids are teenagers now, and my son may be getting his wisdom teeth removed soon. I recently got rid of my old pills because someone with experience in the field of addiction gave me this information. He said that teens who come over as visitors to your home may look through the medicine cabinet and help themselves. Your idea of getting the prescription filled for a smaller number of pills sounds great. 

I know of two teenagers who have died as a result of prescriptions stored in the home medicine cabinet. One used his own leftover pain meds from wisdom tooth removal to commit suicide. The other one experimented with his parents meds and overdosed. Those pain medications are dangerous. Lock them up. Or take them to a disposal center. Do not flush, it harms the bay. 

List of Disposal SitesAlameda

Alameda Police Station
(accepts controlled substances)
1555 Oak Street
Mon-Sun, 8am-8pm

Albany

Albany Senior Center
846 Masonic Avenue
Mon-Fri, 9am-5pm

Berkeley

Berkeley Transfer Station
1201 2nd Street
Mon-Sat, 8am-4:30pm

UC Berkeley Tang Center Pharmacy
(accepts controlled substances)
2222 Bancroft Way
Mon-Fri, 8am-5pm

United Pharmacy
2929 Telegraph Avenue
Mon-Fri, 9am-6pm; Sat, 9am-2pm

 Emeryville

Emeryville Senior Center
4321 Salem Street
Mon-Fri, 9am-5pm

Oakland

Alameda County Household Hazardous Waste*
2100 E. 7th Street at 23rd Avenue
Wed-Fri, 9am-2:30pm
Sat, 9am-4pm
Closed Thanksgiving week and December 24-31
*Alameda County residents only. 

EBMUD Administration Building Lobby
375 11th Street at Franklin Street
Mon-Fri, 8am-4:30pm, except EBMUD holidays

Elihu Harris State Building Lobby
1515 Clay Street
Mon-Fri, 8am-5pm, except state holidays

Oakland Fire Department
1401 98th Avenue at International Blvd, or
1445 14th Street at Mandela Parkway
Everyday 8am-8pm (ring the doorbell)

More info here: http://www.ebmud.com/wastewater/bay-friendly-waste-disposal/medicine-dis...