5 ways dentists can help prevent opioid addiction

January 11, 2021

Opioids are safe and efficient pain relief methods that can be dangerous when misused. Unfortunately, opioid addiction is a growing and serious issue, especially among those age 21 and under. In a webinar with Benco Dental, Dr. Sharon Parsons stated that teenagers, particularly athletes, are more vulnerable to addiction. 

Now is the time to consider the role of dental prescriptions in this severe public health concern. 

The problem with opioids and addiction 

Dr. Parsons stated that 96.5 percent of drug addicts initiate substance use before the age of 21. This problem has become a public health issue with devastating effects, including an economic burden of $78.5 billion a year. Here are some numbers that you should know more about: 

 

No one is sure why one person becomes addicted to opioids and not the other. Opioid addiction has no panacea that eradicates the intense need to fulfill the craving.  

 

Why are opioids addictive? 

Opioid medications are often misused, with many patients developing dependency. They are incredibly habit-forming due to their pharmacological effects: reducing pain threshold and allowing emotional detachment from pain. 

 According to Dr. Parsons, “Drug addiction is not a moral failing.” It is a disease that people are genetically predisposed to—Dr. Parsons states that genetics account for 40 to 70 percent of the risk. Addiction involves the midbrain, resulting in receptor downregulation. It eventually leads to depression and heightened cravings. 

 If dental professionals are not careful in prescribingit may unintentionally lead someone to addiction. 

 The World Health Organization suggests that successful recovery services for opioid dependency exist. Putting these in place may reduce the risk of overdose. However, only less than 10 percent of patients who need such treatment have access to it. 

 How can dentists help prevent opioid addiction?
 

Twelve percent of what dental care professionals prescribe are immediate-release opioids. With this in mind, what can dentists do to help overcome the opioid crisis? 

 

Here are five ways dentists can help reduce the opioid crisis: 

  

  1. Do not use opioids as the go-to prescription. 

Opioids are usually given to teenagers who have regular dental appointments, such as wisdom tooth extractions. Emergency room visits for dental concerns prescribe opioids 60 percent of the time.  

Dentists must find alternatives to alleviate pain. Dr. Parsons encourages the use of over-the-counter painkillers such as Tylenol and Advil. 

  

  1. Enact drug screening as a responsibility.

The Center for Disease Control and Prevention (CDC) recommended that clinicians use urine drug testing before starting opioid treatment for chronic pain. Regular drug screening is an efficient way to monitor prescribed medications, controlled prescription products, and prohibited drugs. 

  

  1. Add patient assessment and referral as the norm.

For certain patients, a visit to the dentist is their only contact with the healthcare system. After all, it is impossible to ignore tooth pain and other critical dental complications. 

 

In the U.S., dentists are the second-highest prescribers of immediate-release opioids. If more  doses are prescribed than what the patient needs, these drugs can be acquired and used by a drug-seeking patient. An abuser can also obtain them through a friend or a family member who has not used their entire prescription.  

 

As such, dental care providers have an ethical duty to prescribe responsibly and wisely. It can mitigate the risk of drug misuse and help minimize the rise of the opioid addiction crisis. Aside from that, dentists may be the only opportunity patients receive for intervention and referral to drug abuse treatment program. 

 

  1. Be equipped with the latest information.

The CDC has released recommendations for opioids for people with chronic pain. The guideline was developed to: 

  • Improve communication between healthcare providers and patients about the advantages and risks of prescribing opioids for chronic pain; 
  • Provide a safer and more effective treatment; and  
  • Help minimize opioid use disorder and overdose. 

 

Among the guidelines released by the CDC, three key concepts are relevant for improving patient care and protection:  

  • Non-opioid therapy is recommended for chronic pain outside of ongoing cancer, palliative, and end-of-life treatment. 
  • Healthcare practitioners must administer the lowest possible prescription level.  
  • Clinicians should exercise caution when using opioids, and track all patients closely. As practice owners, we also need to carefully monitor our team members who may exhibit symptoms of opioid addiction. 

 

  1. Patient education is a must.

One way to alleviate the opioid crisis is to help patients and their loved ones be aware of the risks of opioids. For people struggling with opioid addiction, HIPAA requires healthcare professionals and other protected agencies to disclose personal medical records with loved ones. However, patients maintain their right to determine whether they want to reveal their details or not. 

 

As healthcare providers, dental practitioners are on the front lines to help resolve the crisis. Leveraging the combined strength of preventive education and action offers hope for improvement in the days and years ahead. 

 

 

 

Sources: 

  • Dental Care of Patients with Substance Abuse 

https://pubmed.ncbi.nlm.nih.gov/10516924/  

  • New CDC Guideline Will Help Improve Care, Reduce Risks  

https://www.cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf 

  • Opioid overdose 

https://www.who.int/news-room/fact-sheets/detail/opioid-overdose 

  • The Science of Addiction 

https://www.hopkinsmedicine.org/opioids/science-of-addiction.html 

  • Opioid Overdose Crisis 

https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis#:~:text=2018%20data%20shows%20that%20every,die%20after%20overdosing%20on%20opioids.&text=The%20misuse%20of%20and%20addiction,as%20social%20and%20economic%20welfare 

  • Opioid Addiction 

https://www.ncbi.nlm.nih.gov/books/NBK448203/ 

  • Teens still commonly prescribed opioids, study finds 

https://www.nbcnews.com/health/health-news/teens-still-commonly-prescribed-opioids-study-finds-n1009786 

  • Opioid Prescribing in Dentistry 

https://id.cdeworld.com/courses/5061-opioid-prescribing-in-dentistry 

  • Urine Drug Testing 

https://www.cdc.gov/drugoverdose/pdf/prescribing/CDC-DUIP-UrineDrugTesting_FactSheet-508.pdf 

  • Opioid Data Analysis and Resources 

https://www.cdc.gov/drugoverdose/data/analysis.html 

  • Opioid Overdose Deaths by Age Group 

https://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-group/?currentTimeframe=0&selectedDistributions=0-24&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D