Oral surgeon urges wider use of opioid alternative

Posted at 9:38 PM, May 11, 2018
and last updated 2018-05-11 22:23:26-04

GRAND RAPIDS, Mich. -- With the opioid epidemic running rampant, doctors are looking for alternatives to help ease the pain of their patients.  One oral surgeon in Kent County is using a relatively new drug to prevent pain, but it comes with its own set of challenges.

The drug is called Exparel. It's an injection done at the surgical site the day of that lasts for a few days. For one man who was addicted to heroin and other drugs for 15 years, it made a world of difference for his most recent surgery.

Tyler Trowbridge knows what it means to hit rock bottom.

"I just kind of took the easy way out and started using drugs to kind of numb myself. It was pretty much the only way I could get through each day," he said.

He started to use drugs like heroin and cocaine when he was 18 and battled addiction for the next 15 years.

"You lose everything," Trowbridge said. "You lose family, friends, house, job-- you lose everything until you're in jail, homeless, everyone hates you."

Trowbridge has now been clean for 11 weeks with the help of a friend from high school.  However, the signs of addiction were left behind on his body, his teeth in particular.

"He has a lot of broken down teeth with a lot of cavities here, particularly in the front here and a lot of decay is going right into the pulp there so that’s the source of his extreme temperature sensitivity and cold sensitivity,” said oral surgeon Dr. Mark Jesin.

Trowbridge was introduced to Dr. Jesin,who aggreed to do his procedure for free.

"I was blown away by the level of support he was getting, his commitment to his recovery, the team that supporting him and around him and I wanted to be a part of that as well," Dr. Jesin said.

Because Trowbridge is a recovering addict, opioids post-treatment were out of the question.

"We decided to use local anesthesia and some nitrous oxide, laughing gas, to help him relax throughout the procedure," Dr. Jesin said.

At the end, Dr. Jesin used Exparel instead of prescribing opioids for the pain.

"It slowly releases pain medication into the surgical site over the course of 3, 4 days," he said "It’s non-addictive and it’s known to be as effective as opioid medications."

The drug isn't covered by Medicare, making each vile cost a few hundred dollars. Dr. Jesin paid out of pocket for Trowbridge's surgery.

"All doctors have to realize that prescriptions we prescribe can make a really big difference and we are a major gateway to opioid misuse," he said. "That's one of the major barriers right now to use these medications is that there's very poor reimbursement from Medicare and so we want to encourage our lawmakers to improve access to those medications by improving the reimbursement for them."

Dr. Jesin says he wants to urge lawmakers to get involved to make these opioid alternatives more available to people.

He also says while the drug Exparel is FDA approved, it's not for use on minors.  Many of his patients are people under 18 getting their wisdom teeth out, which is also often their first exposure to opioids.  He wants to make Exparel approved for use on minors as well to help with that aspect.