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In Vermont, giving dentists tools to combat opioid crisis

February 11, 2019

By Kimber Solana

Phil Scott, JoLinda LaClair, Austin Eubanks and Mark Levine
Taking action: From left, Gov. Phil Scott; JoLinda LaClair, director of the governor’s Drug Prevention Policy; Austin Eubanks, chief operations officer at the Foundry Treatment Center; and Mark Levine, M.D., Vermont Department of Health commissioner, chat during a Feb. 4 continuing education event on the opioids crisis organized by the Vermont State Dental Society.

Burlington, Vt. — In front of about 200 people, including over 100 dentists, Austin Eubanks recalled the worst day of his life — witnessing the death of his best friend and sustaining injuries during the 1999 Columbine High School shooting in Colorado.

The physical and emotional pain from the massacre sent him into a downward spiral and a dependence on painkillers.

“I survived the Columbine shooting but addiction almost killed me,” Mr. Eubanks told the crowd.

Mr. Eubanks, chief operations officer at the Foundry Treatment Center, was among the guests and speakers during a Feb. 4 continuing education event on the opioid crisis organized by the Vermont State Dental Society, Vermont Department of Health and the Vermont Prescription Monitoring System.

Aptly called, Spotlight on Opioid Addiction, it was part of an ongoing effort by the state dental society to educate its members about their role in addressing the opioid crisis. The event’s goal: to spread awareness about what has contributed to the opioid crisis and the ways that dentists can work together with other health care professions to address the needs of individuals facing opioid addiction.

“He stressed the importance of allowing one’s self to feel the emotional pain in order to heal. Opioids help with physical pain but should not be used to treat emotional pain,” said Dr. Cassandra Coakley, Vermont State Dental Society president. “Austin spoke about America’s culture of avoiding pain or discomfort and how it has fueled the fire of opioid addiction.”

Dr. Coakley
Dr. Coakley
According to the National Institute on Drug Abuse, Vermont is among the states with the highest opioid-related overdose death rates. In 2017, there were 108 reported opioid-related deaths in the state, the Vermont Department of Health reported.

In 2017, Vermont passed legislation geared towards decreasing the number of opioid prescriptions written. The event provided an opportunity for member dentists, policymakers and government officials attending the event to learn more on how the Vermont health care community is helping to manage the opioid crisis and ensure patient safety, said Vaughn Collins, Vermont State Dental Society executive director.

“Of course, some patients may still need them but they will receive less opioids and for a shorter durations,” Dr. Coakley said. “In my own practice, I have seen patient expectation and desire for opioid prescriptions significantly drop off as patient education about addiction has increased.”

Along with Mr. Eubanks, member dentists at the continuing education event heard from Gov. Phil Scott; Dr. Stephen Leffler, interim president of the University of Vermont Medical Center; Mark Levine, M.D., Vermont Department of Health commissioner; and Hannah Mason Hauser, program manager of Vermont Prescription Monitoring System.

Mr. Collins first heard Mr. Eubanks share his story at the 2018 President-Elect’s & Management Conference at the ADA Headquarters.

“It was important to us to bring him to Vermont. He has a gift of imparting his story in an unbelievably human way,” said Mr. Collins, adding that the Vermont State Dental Society plans to bring in another speaker on opioids for a continuing education session at its annual meeting in the fall.   

Mr. Collins credits the ADA for taking a lead in advocating to keep opioid pain relievers from harming dental patients and their families and working to raise professional awareness on medication alternatives to opioids.

In March 2018, the ADA announced an updated policy opioids, becoming one of the first major health professional organization to support mandatory continuing education for opioid prescribers with an emphasis on preventing drug overdoes, chemical dependency and drug diversion. The ADA policy also supports limiting the dose and duration of initial opioid prescriptions for acute pain and the use of state prescription drug monitoring programs. This was built on a 2016 ADA policy on the use of opioids, stating that dentists should consider nonsteroidal anti-inflammatory analgesics, or NSAIDS, as the first-line therapy for acute pain management.

The following month, the Journal of the American Dental Association published a number of articles related to efficacy of medications for relief from acute dental pain, including a look at dental opioid prescribing, an analysis of sex and race or ethnicity disparities in opioid prescriptions, an overview of systematic reviews on the benefits and harms associated with analgesic medications and an outline covering what a prescription monitoring program can tell dental professionals and why it is important.

As a public service, the ADA Center for Professional Success website offers free access to information on safe prescribing, online continuing education and other tools for managing dental pain. Visit Success.ADA.org/en/wellness/opioid-education-for-dentists.

“Vermont dentists, just like any other health care provider, need to help educate patients about pain and the addictive nature of opioids,” Dr. Coakley said. “Vermont State Dental Society is thrilled to take this leadership role and to help lead this conversation on opioid reform.”