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ADA asks Senate Judiciary committee to include dental profession's concerns in opioid legislation

May 23, 2018

By Jennifer Garvin

Washington — As the Senate Judiciary Committee looks this week at legislation focused on ending the nation's opioid crisis, the ADA is urging lawmakers to include dental providers in the solution.

"As you know, the ADA recently expressed support for mandatory continuing education for opioid prescribers, limits on the number of pills that can be prescribed for initial acute pain and mandatory use of prescription drug monitoring programs," wrote ADA President Joseph P. Crowley and Executive Director Kathleen T. O'Loughlin in a May 22 letter to the committee. "We believe our policy is the first of its kind among major health professional organizations and a sign of how seriously we take this issue."

The Association urged the committee to take a measured approach when considering mandatory continuing education, prescribing limits and prescription drug monitoring programs.

Drs. Crowley and O'Loughlin stressed that any continuing education mandate "emphasize the clinical skills needed to prevent drug overdoses, chemical dependency and diversion."

They also asked for the following components to be included for CE:

  • All credits should be acceptable for Drug Enforcement Administration registration and state licensure renewal purposes.
  • Coursework should be tailored to the prescriber's scope of practice and the nature of pain managed (e.g., chronic vs. acute pain, dental vs. medical pain, etc.).
  • Affected dentists should be given a reasonable amount of time to comply.

The ADA also said it supports limiting opioid prescriptions to no more than a seven day supply of pills for the initial treatment of acute pain and asked legislators to clarify that "this prescribing limit is for the initial treatment of acute pain."

"[T]he seven-day limit is based on the cursory mention of acute pain in the [2015 Centers for Disease Control and Prevention] Guideline for Prescribing Opioids for Chronic Pain," Drs. Crowley and O'Loughlin wrote. "We are hopeful that the CDC will follow-up with a guideline that focuses expressly on best practices for managing acute post-operative pain, which would be more relevant to the average dentist."

In closing the ADA asked the committee to address the need for prescription drug monitoring programs to be easier to use and for the data to be more reliable and available across state lines.

"Our main criticism of the federal response to the opioid crisis is that federal agencies have not sufficiently addressed best practices for managing acute pain versus chronic pain," they concluded. "Federal efforts have also not sufficiently addressed best practices for managing post-operative dental pain, which is more nuanced than managing pain in medical settings. For those reasons, the federal response to date has not been particularly helpful to dentists."

The ADA also sent a letter to the House Judiciary Committee, which shares jurisdiction over the requirements associated with obtaining or renewing a Drug Enforcement Agency registration to prescribe controlled substances, as required by the Controlled Substances Act.

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