Rutgers Study On Ibuprofen/Acetaminophen As Opioid Alternatives

NEW BRUNSWICK, NJ — The Rutgers School of Dental Medicine was awarded an $11.7 million grant from the National Institutes of Health this September so Rutgers can do research on the combination of ibuprofen and acetaminophen as an alternative to opioids.

For example, after dental surgery, such as having your wisdom teeth taken out, people are commonly prescribed synthetic opioids such as Vicodin for the pain. However, because of the high risk of addiction to opioids, Rutgers researchers want to see if prescribing regular old Advil or Tylenol can just as effective.

What's the difference between opiate and opioid? An opiate is a natural substance derived from the opium poppy plant, and an opioid is a synthetic, lab-made substance from the poppy plant, including drugs such as methadone, fentanyl, hydrocodone and oxycodone.

This will be the largest study of its kind, as the Rutgers study will involve 1,800 subjects, all of them Rutgers dental school patients. The students will be prescribed pain medicine after molar extractions and will be followed for up to seven days post-surgery.

The study will also be conducted at other dental schools, not just Rutgers, including the University of Illinois, the University of Maryland, the University of Michigan and the University of Rochester.It will last for up to six years.

The grant, which will support principal investigator and study lead Dean Cecile A. Feldman for up to six years, is from the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health.

According to Feldman, dental clinics are an ideal setting for opioid research because dentists and oral surgeons prescribe the drugs at higher rates than many other medical practitioners.

“A large part of our job is managing acute and chronic pain,’’ she explained. “We want, as much as possible, to duplicate real-life conditions in the clinic."

Rutgers dental students start treating patients in their third year, and this study will involve the patients.

For the study, half of the patients will be receiving a compound of acetaminophen and the lab-made opioid hydrocodone, known as Vicodin, while others will be treated with acetaminophen and ibuprofen. For seven days, they will keep a log tracking their level of pain, self-dosages and common opioid side effects such as nausea and sleep quality.

“The pain isn’t the only thing you need to take into consideration,’’ said Feldman. “People will put up with a slightly higher level of pain if they can avoid side effects and have a higher quality of life during the recovery period.’’

Future opioid use will also be tracked to see if subjects who received opioids were more likely to use or abuse them over time.

In pilot studies at Rutgers dental school, patients who received the ibuprofen and acetaminophen reported fewer side effects than patients who received opioids, and their levels of pain reduction were comparable.

“We’re very hopeful that the results of our research could significantly reduce America’s epidemic levels of opioid abuse while still providing relief for pain,’’ said Feldman.