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ADA outlines efforts to address opioid crisis

November 06, 2017

By Kimber Solana

The ADA outlined its efforts to curb the widespread misuse and abuse of prescription opioid pain relievers in a letter sent Nov. 6 to Chicago, Cook County and DuPage County officials.
"Like you, we are alarmed by the severity of opioid misuse and abuse in the United States, and we recognize that we can all do more to keep opioid pain medications from becoming a source of harm," ADA President Joseph P. Crowley and Executive Director Kathleen T. O'Loughlin said in the letter. "Dentistry continues to make progress on this issue."
The message was in response to a letter city and county officials sent Oct. 27 asking what the ADA and other health care-related groups are doing to address prescription opioid abuse. The letter, which was also sent to the Chicago-based American Medical Association and American Pharmacists Association in Washington, called for the groups to adopt a policy limiting opioid prescribing to no more than seven days for acute pain.
In Cook County, there were at least 1,091 deaths due to opioid overdose in 2016, a 69 percent increase from the year before, according to the letter signed by Chicago Mayor Rahm Emanuel, DuPage County Board Chairman Dan Cronin and Cook County Board of Commissioners President Toni Preckwinkle.
"DuPage County, meanwhile, had over 200 opioid deaths in 2015, and then in 2016 saw 100 percent increase in deaths from fentanyl alone and a 370 percent increase in deaths from fentanyl mixed with heroin," the officials' letter said. "Opioid deaths are now plaguing cities, suburbs and rural areas alike."
Drs. Crowley and O'Loughlin responded by highlighting the ADA's efforts in recognizing the severity of opioid misuse and abuse, and the strides it has made in educating dentist members about how they can help mitigate the crisis.
In 2016, then-ADA president Carol Gomez Summerhays published an open message urging dentists to take several actions to prevent opioid abuse by their patients. These steps included being more judicious in their opioid prescribing when less aggressive treatments are indicated and to also make sure patients leave their offices knowing about their abuse potential and how to safely secure, monitor and discard their unused medications at home.
In addition, the ADA updated its policy for managing dental pain, especially for patients who are at risk for drug overdose and/or addiction and encouraging dentists to consider using non-narcotic medications as a first-line pain therapy.

The ADA also has offered free online continuing education on safe and effective opioid prescribing since 2012. The Association also developed "The ADA Practical Guide to Substance Use Disorders and Safe Prescribing." The clinical reference manual includes techniques dentists can use to manage pain for patients who may be at risk for substance dependence.

In October, the ADA submitted comments urging the Senate Committee on Health, Education, Labor and Pensions and House Committee on Energy and Commerce to better distinguish pain management in dentistry from pain management in medicine, specifically when it comes to managing acute pain versus chronic pain.

Drs. Crowley and O'Loughlin also noted the efforts of the Illinois State Dental Society and the Chicago Dental Society, which have engaged their members in a number of local educational activities and outreach.

The ADA letter invited the elected officials to visit the ADA Headquarters to identify evidence-based and common sense strategies that can be implemented locally to end the crisis.

In the meantime, the ADA letter said, the ADA will continue raising professional awareness about prescription opioid abuse and offering resources to promote more judicious prescribing of prescription pain relievers.

"Rest assured, we will do everything in our power to address this problem," Drs. Crowley and O'Loughlin said.