A Tough Pill to Swallow

A painful truth about the prescription opioid epidemic is that dental prescribing habits are inadvertently contributing to it. In 2012, healthcare providers wrote an astounding 259 million prescriptions for opioids, such as hydrocodone (eg, Vicodin, Lortab) and oxycodone (eg, OxyContin, Percocet). Dentists are among the leading prescribers of opioid analgesics, and surgical tooth extraction is one of the most frequently performed dental procedures. Opioids are regularly prescribed following this procedure. This may represent an important area of excessive opioid prescribing in the United States. While no one wants to see patients in pain, dentists have to step back and ask if there is a better way to resolve the pain while protecting patients from harm. 

Drug overdoses are the leading cause of accidental deaths in the United States, with opioid addition making up 18,893 of the 47,055 drug overdose deaths in 2014. This is a dramatic increase over the past 15 years. Meanwhile, the problem does not end with opioid overdoeses. While many believe these drugs are not dangerous because they can be prescribed by a doctor, abuse often leads to dependence. For some people, opioid misuse and dependence spirals into heroin addiction-four in five heroin users started their addictions misusing prescription painkillers. 

One way to help our patients is through educating ourselves about the problem and strategies through which each one of us can help control the epidemic. In fact, the American Dental Association encourages continuing education on this very issue in order to "promote both responsible prescribing practices and limit instances of abuse and diversion."  

Along with reading this excellent article, dentists can register with the state prescription and drug-monitoring program to help determine which of the patients may be doctor shopping for opioid medications.  Dentists can also encourage patients to take advantage of National Prescription Drug Take-Back Day events and prescription drug disposal sites in their areas.