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A message from the ADA president

Dentistry's role in preventing prescription opioid abuse

July 05, 2016 Dear Colleagues:


Dr. Summerhays
We have all heard the stories of celebrities who have died from overdosing on prescription painkillers. The stories are tragic, and they are not limited to the rich and famous. In 2014, over 47,000 people died from drug overdoses, and 40 percent of those (18,893 deaths) involved opioid analgesics, according to the Centers for Disease Control and Prevention. This doesn't count the nearly 2 million Americans the Substance Abuse and Mental Health Services Administration said reported abusing or being dependent on prescription pain relievers.

This month's Journal of the American Dental Association revisits dentistry's role in preventing prescription opioid abuse. The good news is that data from South Carolina's prescription drug monitoring program shows that a "notable minority of dental patients had incidents of multiple preexisting opioid prescriptions." The bad news is that research on dental prescribing practices is still scant, leaving lawmakers to make far-reaching policy decisions based on anecdotal evidence and haphazard assumptions.

Patients have a responsibility to use opioid painkillers only as prescribed and to keep their unused medications from getting into the wrong hands. We can empower them by being more judicious in our prescribing when less aggressive treatments are indicated. We can also make sure patients leave our offices knowing about their abuse potential and how to safely secure, monitor and discard them at home.

Today, I am asking dentists everywhere to take several specific steps to help prevent opioid pain medications from being inadvertently misused and abused. These actions would complement what the ADA has been doing for several years to raise professional awareness about prescription opioid abuse and provide resources to help prevent it.

  • Register for the next ADA Continuing Education Recognition Program webinar on model opioid prescribing in the context of modern drug-seeking behavior. The webinar is free, convenient to access and available to members and nonmembers alike. Plus, the ADA CERP credential provides a sound basis for state regulatory agencies to accept the continuing education credit for licensure. The next webinar is scheduled for Aug. 24. To register, visit ADA.org/opioids.
  • Use your state's prescription drug monitoring program. These state-run databases can help dentists quickly identify doctor shopping patients based on their prescription history. Find your state prescription drug monitoring program at NASCSA.org.
  • Review the "ADA Practical Guide to Substance Use Disorders and Safe Prescribing." This easy-to-use reference manual includes techniques dentists can use to identify and respond to suspicious drug-seeking behaviors, including after-hours requests for prescription drugs. The guide is available at Catalog.ADA.org.
  • Visit the ADA Center for Professional Success to review ADA resources and previous webinars on opioid prescribing and abuse prevention topics. Learn more at Success.ADA.org.
  • Tell your patients to visit MouthHealthy.org/meds, where they can learn about the dangers of using opioid pain medications for non-medical purposes. Many do not know that using these drugs other than prescribed is illegal, dangerous and can even be fatal.
  • Urge your patients, especially parents, to sign the Medicine Abuse Project pledge to safeguard their medicines and talk with their families about medicine abuse. Unused prescription drugs can be easier to get than illegal drugs, especially when they are left unguarded in the family medicine cabinet or dumped in the trash. Learn more at MedicineAbuseProject.org.
  • Participate in (or possibly host) a National Recovery Month event in September. The Recovery Month campaign is designed to help overcome the stigma associated with addiction and recovery. A broad base of support can inspire those struggling with an addiction to begin the lifelong journey of recovery. Learn more at RecoveryMonth.gov.
We are also revisiting the ADA's Statement on the Use of Opioids in the Treatment of Dental Pain.

Make no mistake: Dentistry has not been idle on this issue. Between 2003 and 2012, dentists dropped from being the second most frequent prescribers of opioid pain medications, according to the Food and Drug Administration, to fifth in the National Prescription Audit —behind family practitioners, internists, general practitioners, and surgeons. In fact, the greatest percentage decrease in opioid prescribing rates between 2007 and 2012 occurred in emergency medicine (–8.9 percent) and dentistry (–5.7 percent), according to a study that looked at opioid prescribing rates by specialty between 2007-12 that was published in the September 2015 edition of the American Journal of Preventive Medicine. It is a part of the story that needs to be told.

We can all do more to keep opioid pain medications from becoming a source of harm. For its part, the ADA will continue raising professional awareness about the issue and offering resources to help prevent it. It will also continue pressing for common sense policies that weigh the need to use opioids for effective pain management against their abuse potential.

Together, we can help stem the tide of opioid abuse that has been devastating our families and communities.

Find out more at ADA.org/opioids.

Sincerely,

Carol Gomez Summerhays, D.D.S.
ADA President