Wisdom teeth removal without pills? Charlotte-area surgeon looks to nix opioid prescriptions

Local surgeon using alternatives to opioids

PINEVILLE, NC (WBTV) - New in the operation room, and at home - pain management, in a different form.

“Traditionally, narcotics had been the only means we had to address [surgery-related pain],”Dr. Amir Marashi of Greater Charlotte Oral & Facial Surgery says.

But now, Marashi says, his practice is introducing other methods.

“With the opioid epidemic, [opioid use] has gotten really out of control,” he says.

He now prescribes a medicine called Dispose RX, which uses warm water to turn leftover pills into a useless goo, that goes in the garbage. It prevents the wrong person from grabbing them from a medicine cabinet.

“Invariably, a lot of those get abused,” Marashi says.

But now, he can even do surgeries like wisdom teeth removal, without prescribing anything. He uses something called Exparel, which is administered during surgery. It’s similar to an anesthetic like nova Caine, but lasts much longer.

“Most local anesthetic runs out in two to three hours,” Marashi says. “But this will last three to four days.”

Many times, the wisdom teeth removal surgery is a young person’s first exposure to a drug that could later be abused.

Michael Harvey is one of Marashi’s first patients who didn’t need any.

“I was actually pretty shocked,” Harvey says. “You could definitely tell after the initial period, three to four days, that the pain did start to come back a little bit, but that to me proves that the Exparel did work.”

With North Carolina’s Department of Health and Human Services reporting 523,251,000 opioid pills prescribed in 2017 alone, Dr. Marashi is hoping to do his part to bring that number down to zero.

“It makes me sleep better at night,” he says. “Knowing that I’m not contributing to this, it makes me happy.”

Marashi says these alternatives are also used in some general surgeries.

For the Exparel, right now patients have to pay a bit extra, but he tells WBTV the Centers for Medicare and Medicaid have just announced reimbursement codes that will start in January.

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