Deaths from drug overdoses have increased significantly in recent years across the United States, becoming the leading cause of accidental death in our country. These deaths are driven largely by an explosion in addiction to opioids, a class of drugs that include the illegal drug heroin as well as legal prescription pain relievers, such as oxycodone, codeine and morphine. This class of drugs works with the nervous system to produce pleasurable effects and relieve pain.

The rate of heroin overdose deaths almost quadrupled between 2000 and 2013. Deaths from overdoses are reaching levels similar to the HIV epidemic at its peak. Kaiser Health News recently reported that medical services for people dependent on opioids rose more than 3,000 percent between 2007 and 2014.

But, before you dismiss this blog because you know your teen would never use heroin, please consider that most heroin addicts never set out to use heroin either. In fact, 80% of heroin users started with prescription drugs. Many heroin users are people who were given prescription painkillers after surgery and had no history of substance abuse.

It is standard for doctors to prescribe a type of opioid following surgery. In fact, dentists prescribe about 8% of all opioids for toothaches or post-dental surgery, such as removal of wisdom teeth (a common procedure for teenagers). Dentists will usually prescribe Vicodin, OxyContin, or Percocet after the procedure. The problem is that these painkillers are highly addictive, and it doesn’t take long to get hooked. Over time, the user develops a tolerance to opioids and needs to use more and more to achieve the same pleasurable feelings. If a patient is not warned of the potential for dependence, they can quickly become an addict.

For example, Brittany Ringersen, founder of the Lighthouse Recovery Institute in Florida, is a former heroin addict (currently 7 years clean). At age 16, she had her wisdom teeth removed. She was prescribed a 30-day supply of Percocet. Despite having pain for only a few days, Ringersen continued taking the Percocet because it gave her a sense of ecstasy. She didn’t realize that there was anything wrong because there were extra pills left in the bottle from a legitimate doctor, and her parents never questioned it.

Once a patient runs out of their prescription pills and cannot get anymore (their doctor won’t prescribe more and no family or friends have excess painkillers at home), many turn to the more affordable heroin. In fact, 94% of respondents in a 2014 survey of people in treatment for opioid addiction said they chose to use heroin because prescription opioids were “far more expensive and harder to obtain.” Once they start using heroin, they are put further at risk because drug dealers will often mix heroin with fentanyl, which is an even more potent opioid and more likely to cause a drug overdose. In addition, new versions of these drugs appear frequently. The Centers for Disease Control and Prevention just announced that a street drug that combines fentanyl and a new synthetic opioid is being sold illegally as the prescription painkiller Norco and cautions that the street version is much stronger and more hazardous than the real medication.

Ironically, Dr. Paul Moore, Professor of Pharmacology and Anesthesiology at the University of Pittsburgh School of Dental Medicine, says half of all dental patients will get effective relief for toothaches and dental surgery from an over-the-counter pain medicine, such as ibuprofen or acetaminophen.

Parents: the most important point you can take away from this blog is that you need to:

• inform your teen of the dangers of prescriptions
• always start with the lowest doses when treating pain
• never use the medication in any way other than what is specifically prescribed (for example, if pain is increasing, don’t just use more of the medication, contact your doctor)
• stop taking opioids as soon as the pain starts to improve

If you, or anyone you know (especially your teenager), is prescribed an opioid, you might try over-the-counter painkillers first to see if it will manage the pain effectively. If you do need something stronger, use the prescription for one or two days at the lowest dose possible, and then, try again to manage the pain with ibuprofen or acetaminophen. Monitor your teen’s usage to make sure that they are using the opioids less and less rather than more and more. Additionally, once the prescription is no longer needed, get rid of the drugs. Visit the DEA’s website or call 1-800-882-9539 for more information and to find an authorized collector in your community.