title: Otolaryngology Concerns for Illicit and Prescription Drug Use.
abstract: Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasoseptal perforation. Further, the Food and Drug Administration has taken a stance against codeine for pediatric patients undergoing adenotonsillectomy. They have identified an increased risk of death postoperatively with these medications. Because codeine has been the most commonly prescribed narcotic, this has shifted the standard practice.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, ENT Clinic, Children's Hospital of Michigan, Wayne State University School of Medicine, 3rd Floor Carl's Building, 3901 Beaubien Avenue, Detroit, MI 48201, USA. Electronic address: ngonik@dmc.org.
authors.forename: Nathan J
authors.initials: NJ
authors.lastname: Gonik
authors.affiliation: Department of Pathology, Wayne State University School of Medicine, 540 East Canfield, Detroit, MI 48201, USA; Consolidated Laboratory Management Systems, 24555 Southfield Road, Southfield, MI 48075, USA.
authors.forename: Martin H
authors.initials: MH
authors.lastname: Bluth
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects; D003061:Codeine / Q000009:adverse effects; D062787:Drug Overdose / Q000175:diagnosis; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity; D009294:Narcotics / Q000009:adverse effects*; D061270:Nasal Septal Perforation / Q000139:chemically induced*; D009666:Nose / Q000187:drug effects* / Q000473:pathology; D010020:Osteonecrosis / Q000139:chemically induced* / Q000175:diagnosis; D010036:Otolaryngology; D019966:Substance-Related Disorders / Q000150:complications / Q000175:diagnosis*
chemical_list: D000701:Analgesics, Opioid; D013287:Illicit Drugs; D009294:Narcotics; D003061:Codeine
keywords: Black box; Cocaine; Codeine; Narcotic; Otolaryngology; Sinonasal