Actiq is a sort of “lollipop” which contains some an opioid drug. It’s meant for cancer patients who, I presume, can no longer swallow a pill, or for some other reason just don’t tolerate an ingested drug.
There’s a story in our local news about a doctor who’s in trouble for overprescribing narcotics, and the article mentioned how this waitress who had been using Actiq lost her teeth. How and why would that happen because of the drug?
It would have been helpful if you could link to the story you mentioned to find out how many lollipops the waitress was using.
According to the drug information insert, the inactive ingredients include citric acid, modified food starch and confectioner’s sugar. Any or all of these can cause tooth decay (or damage) and loss. Interestingly, in clinical trials, less than 1% of patients reported tooth decay, although gingivitis (gum inflammation) was reported in more than 1% of patients. (I can’t give exact figures; adverse reactions were listed as greater than 1% and less than 1%.)
FTR, Actiq isn’t for people who can’t swallow. It’s for patients who are already on high doses of narcotic pain meds who still need pain relief between scheduled doses. There are other routes of administration for patients who can’t swallow. The same drug in Actiq, fentanyl, is available in a patch for absorption through the skin. There are also portable pumps through which liquid medication can be injected. There are other ways to get pain meds into a patient who can’t ingest or tolerate oral medications.
IANAD, of course, and if I’m wrong on any of this, I’m sure someone will be along to help.
Robin
But the inactive ingredients in actiq are in all lollipops pretty much.
So would it be fair to say that actiq has just as much chance of making you lose your teeth as the lollipops sold at candy stores?
I suppose the addiction to the active ingredient would drive you to keep it in your mouth more than you would an ordinary lolly, so maybe the sugar and citric acid has a greater opportunity to damage your teeth.
and if you’re that addicted to a drug, no matter how its administered, wouldn’t your personal care decline somewhat?
Not necessarily, Mynn. There are lots of functioning drug addicts out there whose hygiene is no different from yours or mine.
As I said, though, it’s hard to make a blanket statement about someone’s Actiq usage without knowing how much she was using. Was it 1 or 10 or 100 lollipops a day?
Robin
In general, all narcotics -licit or not- decrease salivation, which has a number of protective effects on teeth, especially during sleep. Most antihistamines, many neurological drugs, and some blood pressure medications can also cause this effect, but it is not generally as bad.
It’s not unique to Actiq.
I’m sorry. I meant to put some qualifiers in there: “almost any narcotic -licit or illicit- can alter the quality or quantity of salivation.”
The original statement was overly broad. However, dental problems are fairly common in abusers of narcotics, sedatives (including many over the counter sleep aids) and other drugs. They are not uncommon in patients who take these drugs as prescribed either. I wouldn’t say that the drugs cause tooth decay or gingivitis, but they do act as a predisposing factor added to improper care and genetic predisposition
What I was thinking was that anything sugary that is kept in the mouth, next to the teeth, is going to cause decay from sheer proximity. It’s not really different from cough drops or any other hard candy.
Robin