Dentists Urged to Fight Painkiller Abuse
“Dentists write the third-most prescriptions for immediate release opioids in the United States.”
The Journal of the American Dental Association came out swinging in its July issue, featuring a cover story on “The Dentist’s Role in Preventing Prescription Opioid Abuse,” and offering some practical safeguards. “Many dentists really haven’t even perceived there to be a problem,” said George Kenna, an assistant professor of psychiatry and human behavior at Brown University, who is one of the authors of the paper. “Dentists write the third-most prescriptions for immediate release opioids in the United States, but they often don’t know the appropriate number of doses to prescribe, how many doses a patient uses, or most importantly what patients do with the leftover tablets they have.” The amped-up coverage is part of President Obama’s attempt to highlight prescription painkiller abuse. A 2010 survey by the University of Charleston in West Virginia, to which more than half of the state’s dentists responded, revealed that 90% of the dentists surveyed prescribed opioids in the prior year. Two-thirds prescribed between 10 and 20 doses of the painkillers, but 41 percent acknowledged that patients would probably have some left over, according to Brown University. “People who have a substance abuse problem do have legitimate pain," said Kenna. "They do have a right to have some pain control and may even need more. But you hope there is a family member who will take control and make sure they only take the recommended dose.”
Kenna and fellow addiction experts and pharmacists at the Tufts Health Care Institute Program on Opioid Risk Management, where he serves as a scientific adviser, helped formulate recommendations for dentists, including:
- Discuss with patients whether they need an opioid for their pain and how likely they are to use what you prescribe.
- Consider writing small quantities and limit refills.
- Be suspicious of those who claim their drugs were lost or stolen.
- Use prescription monitoring programs (i.e., state databases), if available, to verify drug-use history.
- Advise patients either to destroy or lockup any excess medication.
- Keep prescription pads locked up.