Introduction

In the roughly two hours it will take to complete this course, approximately ten Americans will die of an opioid overdose.¹¹ The annual cost associated with the opioid epidemic to the American economy, including healthcare costs, lost productivity, criminal¹² justice expenses, and treatment costs, is estimated to be $78.5 Billion.¹² Dentists represent approximately 12% of the opioid prescriptions written^6,7 and approximately one-third of all prescriptions written by dentists are for opioid pain medications.¹³ Even short-term prescriptions for acute pain may not be innocuous.⁵ Six percent of adults prescribed at least 1 day of opioids will continue to use them 1 year later; 2.9% will continue to use them 3 years later.¹⁴ Early use (before the age of 15 years) of any substance of abuse is associated with a 550% increase in the risk of subsequent substance use disorder (28.1% vs 4.3%),¹⁵ and even the legitimate use of prescription opioids by children before the 12th grade (17-18 years of age) increases the risk of future opioid misuse by 33%.¹⁶ Dentists also report low frequency of prescription drug monitoring program (PDMP) queries, risk screening, and patient education for risk mitigation when prescribing opioid analgesic medication,¹⁷ although rates of use of PDMP are on the rise and recommendations from dental organizations and state provider mandates for PDMP use have been shown to improve utilization.^18,19 Given the role dentists play in the prescription of opioid medications, it is critical that dental healthcare professionals understand the critical role that they can play in mitigating the risks associated with opioid medications.