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The Dental Professional’s Role in the Opioid Crisis

Course Number: 560

Background

Opioid overdoses and deaths related to opioid abuse continue to climb. In 2019, 49,860 Americans were reported to have died from opioid overdoses (70.6% of all US drug overdoses).1 This was a substantial rise from 21,088 in 2010.1 In 2018, the Surgeon General of the United States, Dr. Jerome Adams, stated that the country’s opioid crisis is an “epidemic because people are dying like never before.”2 In February 2018, the American Dental Association (ADA) released updated recommendations for using opioids for dental pain and reaffirmed the use of non-steroidal anti-inflammatory (NSAID) analgesics as first-line therapy for acute pain management.3 There is also data that sheds light on vulnerable populations, including children and teenagers, for whom exposure to opioids may be particularly damaging.4,5 Dentists are responsible for prescribing an estimated 12% of immediate-release opioids annually6,7 and patients report not using 54% of opioids prescribed during dental surgery.8 Opioids that are not used in the initial prescription may be stored and diverted for non-prescription usage. Despite the volume of opioid prescriptions written by dentists, research suggests that dentists have not fully adopted recommended risk mitigation strategies, including screening for prescription drug abuse or misuse, verifying current and past prescriptions using state prescription drug monitoring programs, and providing patient education on safe use, storage, and disposal of medications when prescribing opioid medications for pain management.<sup>9,10</sup>