美国国家公共电台 NPR Dentists Work To Ease Patients' Pain With Fewer Opioids

 

LOURDES GARCIA-NAVARRO, HOST:

As we've been hearing, doctors face a tough challenge. They need to help ease their patients' pain while considering the risks of prescribing opioids. Dentists are often on the front lines of this problem, and they're looking at new - and surprisingly simple - ways to manage pain. Here's Elana Gordon from WHYY's The Pulse in Philadelphia.

ELANA GORDON, BYLINE¹: James Hatzell distinctly remembers that spring day his junior year of high school. He was en route with mom in South Jersey² to get his wisdom teeth out.

JAMES HATZELL: We're in our 2001 Honda Odyssey³ minivan, you know, driving to the dentist. And we get there, and I'm just, like, pumped.

GORDON: Yeah, pumped. This was almost seven years ago. Hatzell was 17, and he knew that right after the dentist cut out his molars, a health professional was going to give him his very own legit bottle of pain pills. On the way home, he could not wait to pop that first one. His mom noticed.

HATZELL: You know, she's, like, sort of, like, looking at me a little bit concerned on how much I'm enjoying this.

GORDON: He turned up a certain Pink Floyd song.

HATZELL: Just, like, totally into it, loving it.

(SOUNDBITE OF SONG, "COMFORTABLY NUMB⁴")

PINK FLOYD: (Singing) Comfortably numb.

HATZELL: And we got home, and my mom took the pills and was like - you can't have these (laughter).

GORDON: So that was it?

HATZELL: Well no, that was not it.

GORDON: He knew exactly where that bottle was hidden - Mom's jewelry⁵ drawer. He emptied out the pills and replaced them with Advil.

HATZELL: I definitely was every parent's (laughter) worst nightmare.

GORDON: Hatzell says he can joke about this now, but that prescription⁶ would mark the start of a downward spiral, one that would include being arrested for dealing⁷ drugs in college.

Each year, some 3.5 million young adults get their wisdom teeth out. Dentists are frequent prescribers of opioids for short-term pain. When Dr. Joel Funari started practicing more than 30 years ago, he says it was common to prescribe 30 or more Vicodins or Percocets after such procedures.

JOEL FUNARI: Dentists don't like to see patients in pain. They want to get them out of pain. You know, we tend to be compassionate⁸ people, and I think we were falling into a trap that we were creating ourselves.

GORDON: Funari practices in a suburb of Philadelphia, and he's part of a group that developed Pennsylvania's first-ever dental guidelines for opioid prescribing. He says research actually shows...

FUNARI: That the Motrins, the Advils, the Aleves, when used in a certain way, were very effective, more effective than the narcotics⁹.

GORDON: They keep the swelling¹⁰ down, which Funari says is a main source of the pain. The guidelines now recommend using these medicines first. It's all a big culture shift. Elliot Hersh, a professor of oral surgery at the University of Pennsylvania, says anti-inflammatory drugs like ibuprofen...

ELLIOT HERSH: They don't have as much hype - why? - because they're available over the counter. And what a lot of the lay public believe is that if they're available over the counter, they're weak and they don't work.

GORDON: The National Dental Association and some other states are now following Pennsylvania's lead in drafting new guidelines. If dentists are going to prescribe opioids, they should use caution and check a statewide database to review patient prescription histories. And Hersh says it's important to take a hard-line approach when training future dentists.

HERSH: I've been teaching my students that if you write too many of these drugs, for either good intentions or bad intentions, either the state dental board and/or the DEA is going to come down on you.

GORDON: But this isn't an exact science. Hersh says a small portion of patients will need an opioid. But it's hard to predict who that will be. James Hatzell does not want to be one of them. He is in year three of his recovery. One of the most terrifying thoughts is that one day he might need surgery and then get prescribed pain meds.

HATZELL: I don't want to take any at all. But, you know, I might be put in a situation where it's medically appropriate for me, and I don't want to have to make that decision.

GORDON: Now when Hatzell goes to the dentist, he says right upfront he cannot take narcotics, which means, more and more, dentists are going to have to figure out how to respond to these tricky¹¹ situations.

For NPR News, I'm Elana Gordon in Philadelphia.

GARCIA-NAVARRO: Her story is part of a partnership¹² with NPR, WHYY's The Pulse and Kaiser Health News.

And next week on The Call-In, I'll be traveling to the Rio Grande Valley along the U.S.-Mexico border talking to landowners, immigrants, Border Patrol officers, business owners and residents. What questions do you have for them? Call in at 202-216-9217. Leave us a voicemail with your full name, where you're from and your question, and we may use it on the air. That number again is 202-216-9217. We want to know your questions about the border.

(SOUNDBITE OF MOSS OF AURA PIECE, "FOOLS")

1 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

2 jersey   

n.运动衫

参考例句：

• He wears a cotton jersey when he plays football.他穿运动衫踢足球。
• They were dressed alike in blue jersey and knickers.他们穿着一致，都是蓝色的运动衫和灯笼短裤。

3 odyssey   

n.长途冒险旅行；一连串的冒险

参考例句：

• The march to Travnik was the final stretch of a 16-hour odyssey.去特拉夫尼克的这段路是长达16小时艰险旅行的最后一程。
• His odyssey of passion, friendship,love,and revenge was now finished.他的热情、友谊、爱情和复仇的漫长历程，到此结束了。

4 numb   

adj.麻木的，失去感觉的；v.使麻木

参考例句：

• His fingers were numb with cold.他的手冻得发麻。
• Numb with cold,we urged the weary horses forward.我们冻得发僵，催着疲惫的马继续往前走。

5 jewelry   

n.（jewllery）（总称）珠宝

参考例句：

• The burglars walked off with all my jewelry.夜盗偷走了我的全部珠宝。
• Jewelry and lace are mostly feminine belongings.珠宝和花边多数是女性用品。

6 prescription   

n.处方，开药；指示，规定

参考例句：

• The physician made a prescription against sea- sickness for him.医生给他开了个治晕船的药方。
• The drug is available on prescription only.这种药只能凭处方购买。

7 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

8 compassionate   

adj.有同情心的，表示同情的

参考例句：

• She is a compassionate person.她是一个有同情心的人。
• The compassionate judge gave the young offender a light sentence.慈悲的法官从轻判处了那个年轻罪犯。

9 narcotics   

n.麻醉药( narcotic的名词复数 )；毒品；毒

参考例句：

• The use of narcotics by teenagers is a problem in many countries. 青少年服用麻醉药在许多国家中都是一个问题。 来自《现代汉英综合大词典》
• Police shook down the club, looking for narcotics. 警方彻底搜查了这个俱乐部，寻找麻醉品。 来自《简明英汉词典》

10 swelling   

n.肿胀

参考例句：

• Use ice to reduce the swelling. 用冰敷消肿。
• There is a marked swelling of the lymph nodes. 淋巴结处有明显的肿块。

11 tricky   

adj.狡猾的，奸诈的；(工作等)棘手的，微妙的

参考例句：

• I'm in a rather tricky position.Can you help me out?我的处境很棘手，你能帮我吗？
• He avoided this tricky question and talked in generalities.他回避了这个非常微妙的问题，只做了个笼统的表述。

12 partnership   

n.合作关系，伙伴关系

参考例句：

• The company has gone into partnership with Swiss Bank Corporation.这家公司已经和瑞士银行公司建立合作关系。
• Martin has taken him into general partnership in his company.马丁已让他成为公司的普通合伙人。