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ADA urges Congress to address acute pain in response to opioids

June 21, 2019

By Jennifer Garvin

Washington — The ADA is applauding Congress' response to the opioid crisis but continues to urge the federal government to place a greater emphasis on managing acute pain in its prevention efforts.

In a letter to the House Oversight and Reform Committee Chair Elijah Cummings, D-Md., and Ranking Member Jim Jordan, R-Ohio, ADA President Jeffrey M. Cole and Executive Director Kathleen T. O'Loughlin thanked lawmakers for holding the June 19 hearing, Medical Experts: Inadequate Federal Approach to Opioid Treatment and the Need to Expand Care.

Drs. Cole and O'Loughlin told Congress that the ADA remains committed to working with legislators, government agencies and other stakeholders to keep prescription opioid pain medications from becoming a source of harm, noting the Association's 2018 policy that called for mandating continuing education and initial prescribing limits for opioids for dentists.

"Our main criticism of the federal response to the opioid crisis is that it has not sufficiently distinguished pain management in dentistry from pain management in medicine, specifically when it comes to managing acute pain versus chronic pain," Drs. Cole and O'Loughlin wrote. "For that reason, the federal response to the opioid crisis has not been particularly helpful to dentists."

The ADA urged lawmakers to better address the nuances of managing acute pain following one-time surgical procedures and recommended that prescriber education opportunities be coordinated with professional societies and administered by an accredited continuing education provider — and that the coursework be dually recognized for state licensure purposes.

"For example, the highly touted Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain does not address the particulars of managing acute pain following a one-time surgery," Drs. Cole and O'Loughlin wrote. "In fact, the document expressly states, 'Some of the recommendations might be relevant for acute care settings or other specialists, such as emergency physicians or dentists, but use in these settings or by other specialists is not the focus of this guideline.' "

The ADA leaders thanked Congress for the Substance Abuse and Mental Health Services Administration's Providers' Clinical Support System for Opioid Therapies that has enabled dentists to participate in continuing education resources, including webinars made possible by a grant from SAMHSA and the American Academy of Addiction Psychiatry. They also noted that National Institute of Dental and Craniofacial Research is currently investigating the biological triggers of dental pain and novel ways to alleviate it using non-narcotic therapies.

"Together, the findings will enable us to target our education and outreach messages to dentists and, ideally, lead them to use non-narcotic pain relievers as the first-line therapy for acute pain management," Drs. Cole and O'Loughlin wrote.  

Follow all of the ADA’s advocacy efforts at ADA.org/advocacy.