Impact of Dentists on Opioid Overprescribing in the U.S.
Overview of the Opioid Crisis
The opioid crisis in the United States has reached alarming levels, with a significant number of drug overdose deaths involving opioids. A study from 2018 found that opioids were implicated in two-thirds of these fatalities. While illegal substances like heroin are part of the issue, prescription opioids are a primary contributor to opioid addiction.
Role of Dentists in Opioid Prescribing
Traditionally, the focus on opioid overprescribing has been directed towards physicians; however, dentists account for 12% of all opioid prescriptions in the U.S. Notably, the rate of opioid prescriptions written by dentists is approximately 37 times higher than that of comparable countries.
New Study on Dental Opioid Prescribing
In light of these statistics, a recent study published in The American Journal of Preventive Medicine investigates the appropriateness of opioid prescribing by dentists. Conducted by a research team at Oregon State University, the study looked into the strength and duration of opioids prescribed during dental treatments by analyzing data from three insurance claims databases.
Methodology of the Research
The researchers used a convenience sample from the databases, applying various inclusion and exclusion criteria to ensure that the analysis focused specifically on cases where dentists prescribed opioids. Patients undergoing chemotherapy or receiving hospice care were excluded, as were those with incomplete information regarding their prescriptions. To facilitate comparisons across different opioids, all dispensed doses were converted to morphine milligram equivalents (MME).
Findings of the Study
The study analyzed over 500,000 dental visits involving opioid prescriptions. It was found that in 30% of cases, opioids were prescribed for mild dental pain. Additionally, 30% of the prescriptions exceeded recommended dosages. Younger male patients were more likely to receive these inappropriate doses, with oxycodone identified as the most commonly overprescribed opioid. Geographic trends showed higher rates of overprescribing in the southern regions of the U.S. Alarmingly, the likelihood of overprescribing increased over the study period. Furthermore, 53% of visits resulted in prescriptions that surpassed the recommended treatment duration.
Implications for Future Prescribing Practices
This study is crucial as the U.S. grapples with an ongoing opioid epidemic. While there are positive national trends in opioid prescribing, dental practices appear to be an exception. The findings suggest a need for re-evaluation of prescribing behaviors among dentists, advocating for the use of non-steroidal anti-inflammatories where appropriate and adherence to guideline recommendations regarding prescription duration.
Need for Further Research
While the study provides valuable quantitative insights, it does not explore the qualitative reasons behind the observed prescribing patterns among dentists. Future research is essential to understand the underlying factors and to develop strategies for changing these prescribing behaviors.
References
Hedegaard H, Minino AM, Warner M. (2018) Drug Overdose Deaths in the United States, 1999-2017. NCHS Data Brief. 2018(329):1-8.
Suda KJ, Zhou J, Rowan SA, McGregor JC, Perez RI, Evans CT, et al. (2020). Overprescribing of Opioids to Adults by Dentists in the U.S., 2011–2015. Am J Prev Med.
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