Overview

Opioid overdoses and deaths related to opioid abuse continue to climb. In 2016, over 64,000 Americans died from overdoses, 21% more than the almost 53,000 in 2015.1 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 emerging research that sheds light on vulnerable populations, including children and teenagers, for whom exposure to opioids may be particularly damaging.4 Dentists are responsible for prescribing an estimated 12% of immediate-release opioids annually5,6 and patients report not using 54% of opioids prescribed during dental surgery.7 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 do not employ significant 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.8,9 This course seeks to improve the dental care provider’s understanding of the role of dental healthcare providers in the primary prevention of opioid abuse and provide them with tools to critically assess the individualized needs of their patients. It will review the current evidence on best practices for analgesic prescribing for acute and post-operative discomfort. It will also serve to give dental healthcare providers the tools to identify individuals who may suffer from substance abuse and refer those patients to resources to help treat their addictions.