Researchers have estimated that 5 to 23% of all prescription opioid doses are non-medically consumed. This number has been on the rise in recent years as more and more opioid prescriptions are written for pain management. An increase in written prescriptions amplifies the accessibility to and misuse of these powerful drugs. But what does opioid misuse have to do with dentistry?
Dentists are the second largest prescriber of immediate release opioids like hydrocodone and oxycodone. “Dentists prescribe 12 percent of IR opioids in the United States, behind only family physicians, who prescribe 15 percent of IR opioids.” In July 2016, ADA President Carol Gomez Summerhays encouraged dentists to educate themselves and their patients to help prevent the continued abuse of opioid medications. This plea complimented the works of the American Dental Association in raising awareness of opioid abuse. “We can all do more to keep opioid pain medications from becoming a source of harm,” Dr. Summerhays wrote. “Together, we can help stem the tide of opioid abuse that has been devastating our families and communities.”
Misused prescription opioids are most commonly transferred between friends and family. Relatives and friends redistribute leftover prescriptions from legitimate medical problems, increasing the likelihood of future abuse and addiction. “ Among people 12 years and older in 2008 and 2009 who used pain relievers nonmedically in the preceding year, 55.3 percent got the drugs they most recently reported using from a friend or family member for free, 9.9 percent bought them from a friend or family member, 5.0 percent took them from a friend or family member without asking, 17.6 percent got them through a prescription from one prescriber (in contrast to obtaining prescriptions from multiple prescribers), and 4.8 percent got pain relievers from a drug dealer or stranger.”
Dentists and Opioid Prescriptions
The American Dental Association (ADA) Survey Center conducted a survey of 563 practicing oral and maxillofacial surgeons regarding opioid prescriptions after wisdom tooth removal. 85% of respondents almost always prescribed an opioid, mostly hydrocodone, after wisdom tooth removal. If you’ve had your wisdom teeth removed, this probably sounds familiar. The standard prescription is around 20 doses with instructions to “use as needed.”
The study reveals that overprescribing is a result of prescribing quantities that any treated patient could need. This includes severe cases as well as mild ones. A quantity of 20 may be needed, but more than likely, any given patient may need less than 10. These leftover pills are then available to ration among other people in need (friends and relatives).
However, this is not to say that dentists intentionally overprescribe. There are many factors contributing to the greater problem. The result of the study was that dentists should take steps to identify the problem with over prescription and work with patients to minimize the threat of opioid abuse.
Takeaway for Dental Patients
Opioid misuse is on the rise and is increasingly dangerous. These drugs are powerful and addictive. If you or your children are prescribed opioids following dental work, be mindful. Take measures to secure opioids during and after use, and follow proper disposal methods when you discontinue use. Both dentists and our patients can all play a part in minimizing the spread of nonmedical opioid abuse. If you have any questions about dosage or use of opioids, please ask. We are here to help you!