Substance Use Disorders in the Dental Practice
Research tells us that dentists are no more—or less—likely to develop substance use disorders (alcohol or drug abuse or dependence) than the general population. In other words, 10–15 percent of dentists will have a drug and/or alcohol problem sometime in their lives.
Substance use disorders are part of the human condition, and touch as many as one in four American families.
What is different for dentists and other health professionals than for the general population is the public trust that goes with the privilege to practice, and the responsibility to obey the state dental practice acts and controlled substance regulations.
An untreated substance use disorder in a dentist can not only threaten the dentist's life and family stability, but place patients, and the practice itself, in jeopardy.
What is Moderate and Binge Drinking
Moderate or "low-risk" drinking
Research shows that people who drink moderately may be less likely to experience an alcohol use disorder (AUD). These drinking levels, which differ for men and women, are:
For men: No more than 4 drinks on any single day AND no more than 14 drinks per week
For women: No more than 3 drinks on any single day AND no more than 7 drinks per week
To stay low risk for AUDs, you must keep within both the single-day and weekly limits.
Even within these limits, you can have problems if you drink too quickly or have other health issues. To keep your risk for problems low, make sure you:
- Drink slowly
- Eat enough while drinking
Certain people should avoid alcohol completely, including those who:
- Plan to drive a vehicle or operate machinery
- Take medications that interact with alcohol
- Have a medical condition that alcohol can aggravate
- Are pregnant or trying to become pregnant
Heavy or “at-risk” drinking
For healthy adults in general, heavy drinking means consuming more than the single-day or the weekly amounts listed above. About 1 in 4 people who drink above these levels already has alcohol dependence or alcohol abuse problems.
Binge drinking means drinking so much within about 2 hours that blood alcohol concentration (BAC) levels reach 0.08g/dL. For women, this usually occurs after about 4 drinks, and for men, after about 5.
Drinking this way can pose health and safety risks, including car crashes and injuries. Over the long term, binge drinking can damage the liver and other organs.
Assistance Services for Dentists
Services are available in most states for dentists at risk of or experiencing impairment. Contact information is available in the 2009 Well-Being Directory online, or by calling 312.440.2622, or the member toll-free number, ext. 2622, or by email to firstname.lastname@example.org. All inquiries are confidential.
Resources for State Dentist Well-Being Programs
A Listserv for well-being committee chairs and the directors of programs that serve dentists has just launched. For information, email email@example.com.
Voices of Experience
Read dentists' stories in these articles from the Michigan Dental Association Journal. All of these articles are available in Adobe PDF format and will open in a separate browser window.
The University of Utah School on Alcoholism and Other Drug Dependencies
The University of Utah sponsors a weeklong summer training school on alcoholism. It is the only school of its kind to have profession-specific sections—and there is a Dental Section. For more information see the University's website.
National Issues Conference Call: Examining Prescription Drug Abuse and the Role of the Dental Professional (PDF)
Speaker: Bob Burns, Drs. Bill Kane and Brett Kessler
Date: February 22, 2012
Webinar: Opioid Analgesia in your Dental Practice: Assessing Risks and Effective Pain Management (PDF)
Speaker: Drs. Pat Sammon and John Lindroth, University of Kentucky Dental School
Date: May 17, 2012; 12:00 PM CDT
Webinar: Chronic Opioid Therapy in Dentistry (PPT)
Speaker: Dr. Jeffrey Crandall
June 27, 2012, 6:00 PM CDT
Annual Session Course: Management of Pain in the Chemically Dependent Patient
Speaker: Dr. Bill Kane
Location & Date: ADA Annual Session, October 18, 2012, 2:00-4:00 PM
2013 Webinars and ADA Conference on Dentist Health and Well-Being/Opioid Track
Opioid Prescribing – Spokane County Dentists (PDF)
Speaker: Amy Riffe, MA, MPH
Date: January 23, 2013
A Statewide Evaluation of Opioid Prescribing Patterns with an Emphasis on Drug Diversion and Substance Abuse (PDF)
Speaker: Michael O'Neil, PharmD
Date: February 20, 2013
Opioids and Non-Opioids Prescription for Dental Care in Emergency Departments in the United States (PDF)
Speaker: Christopher Okunseri, BDS, MSc., MLS, DDPHRCSE., FFDRCSi
Date: April 10, 2013
Strategies in the Dental Office for Safer Management of Patients at Risk for Opioid-Seeking Behavior (PDF)
Speaker: Theresa E. Madden, DDS, MS, PhD, FACD
Date: June 19, 2013
Additional Opioid Prescribing Resources
The Journal of the American Dental Association
For more information on the grant or the webinars, contact Alison Siwek by calling 312.440.2622 or via email at firstname.lastname@example.org.
ADA Current Policies
This downloadable document contains major policies adopted by the American Dental Association House of Delegates from 1954 through 2005 that are still in effect in 2006, except for policies that appear in the Association's Constitution and Bylaws and Principles of Ethics and Code of Professional Conduct.
Under the heading Dentist Health and Well-Being you will find:
- Dentist Health and Wellness
- Substance Abuse Among Dentists
- Substance Use Among Dental Students
- Guiding Principles for Dentist Well-Being Activities at the State Level.
Under Substance Use Disorders you will find:
- Use of Opioids in the Treatment of Dental Pain
- Alcoholism and Other Substance Use Disorders
- Provision of Dental Treatment for Patients with Substance Use Disorders
- Alcohol and Substance Use by Pregnant and Postpartum Patients
- Guidelines Related to Alcohol, Nicotine, and/or Drug Use by Child or Adolescent Patients
ADA Principles of Ethics and Code of Professional Conduct
It is unethical to practice dentistry while under the influence of substances that impair the ability to practice. Dentists who have firsthand knowledge of a colleague's impairment are also under an ethical obligation—and in some cases, a legal obligation—to report the colleague to a dentist assistance program or the state licensing board. Get more information.