Dental Tribune America

Opioid prescription habits of dentists brought into focus again

By Dental Tribune International
February 14, 2020

PITTSBURGH, U.S.: Between 2015 and 2018, the opioid epidemic in the U.S. cost the economy $631 billion, according to a report released by the Society of Actuaries. With such a substantial human and financial impact, there is a crucial need to understand whether the new pain management guidelines introduced by the Centers for Disease Control and Prevention (CDC) in 2016 have curbed the issue. A recent study from the University of Pittsburgh School of Medicine reported that the overprescribing of opioids by dentists was common, particularly for patients at high risk for substance abuse.

The study used Truven Health MarketScan Research Databases to assess close to 550,000 dental visits by adult patients between 2011 and 2015 prior to the implementation of the 2016 CDC guidelines for pain management. From that data, the researchers found that more than half of opioid prescriptions issued by dentists exceed the three-day supply now recommended by the CDC for acute dental pain management. The findings also show that 29% of dental patients received more powerful opioids than needed for expected post-procedural pain.

Opioid prescription by dentists is already in the spotlight after a study by researchers at the University of Illinois at Chicago and the University of Sheffield in England found that dentists practicing in the U.S. write 37 times more opioid prescriptions than dentists in England do, and this new study highlights the issue even further.

“Unlike national trends, opioid overprescribing by dentists is increasing. Our results should initiate a call to action to professional organizations and public health and advocacy groups to improve the guidelines for prescribing opioids for oral pain,” said lead investigator Prof. Katie J. Suda from the Division of General Internal Medicine at the University of Pittsburgh School of Medicine.

Results from Suda and her team’s study also indicated the demographic groups that were most impacted by overprescribing. Patients aged 18–34 years, men, those living in the Southern U.S. and those receiving oxycodone were most likely to have opioids prescribed inappropriately. In a 2019 interview with Dental Tribune International, Dr. David Hamlin, regional dental director at the global health service company Cigna, said: “The highest number of new opioid prescriptions in the dental profession are written for teenagers after oral surgery, yet they are at higher risk of opioid dependency than adults, because their brains are still developing. In fact, young people aged 18–25 are 6.8% more likely than adults to develop an opioid addiction within one year of being prescribed opioids for third molar extractions.”

Co-investigator Dr. Susan A. Rowan from the University of Illinois at Chicago said that “additional studies are needed to evaluate the efficacy of the CDC 2016 prescribing guidelines subsequent to their introduction.” The epidemic is continually evolving, and researchers from the Society of Actuaries reported that in 2019 the opioid crisis would cost another $172–$214 billion, which may indicate that Rowan’s thoughts on further research may be more relevant than ever.

The study, titled “Overprescribing of opioids to adults by dentists in the U.S., 2011–2015,” was published online on Jan. 27, 2020, in the American Journal of Preventive Medicine, ahead of inclusion in an issue.

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