Dentists Need To Make Sweeping Changes To Opioid Prescribing

By Kelly Burch 03/06/19
Dentists have decreased the amount of opioid prescriptions they write by nearly 500,000—but some believe it's not enough.
Image: 
a dentist working on a patient

Three years ago, P. Angela Rake decided to make a major change at her oral surgery practice.  

"After the loss of Prince, I just drew a line in the sand that I'm going to change my prescribing practices," Rake said, according to The Chicago Tribune. In just two years, she reduced the amount of opioids she was prescribing by 70%. 

It wasn’t just the death of the superstar that moved her. Rake had also seen her own brother get hooked on opioids that he was given during cancer treatment. Having seen firsthand the dangers of opioid addiction, she knew that she couldn’t continue to prescribe opioids to her patients in the usual manner. 

Today, she only prescribes opioids when absolutely necessary. The patients who do need opioids get few pills and lower doses. Rake now says she feels like the opioid industry deceived her. 

"When these drugs came into being routinely prescribed, the industry-funded message we were being told was that the risk of addiction was less than 1 percent. We were misled.”

The truth is that the risk of addiction for young people given opioids after oral surgery is closer to 6%. Now, more dentists are becoming aware of the danger of these pills for the youngest patients, said Andrew Kolodny, co-director of opioid treatment research at Brandeis University.

"Dentists and oral surgeons are the No. 1 prescribers of opioids to teenagers. What's so disturbing is that it's so unnecessary. These are kids who could have gotten Advil and Tylenol,” he said. "It's almost a rite of passage in the United States having your wisdom teeth out. The aggressive prescribing of opioids to adolescents may be why we're in an epidemic.”

Dentists have decreased the amount of opioid prescriptions they write by nearly half a million, from 18.5 million in 2012 to 18.1 million in 2017. However, that’s a far cry from the 70% reduction that Rake made, and some within the industry say it is not enough. 

Romesh Nalliah, who teaches at the University of Michigan School of Dentistry and has studied opioid prescribing among dentists, said that dentists are concerned about customer satisfaction, and sometimes that relies on doling out opioids. 

"Dentists are also business owners. They don't want patients to say, 'Dr. Nalliah did my extraction, and now I'm in agony,’” Nalliah said. Despite that, he has now changed the way that he prescribes opioids, and urges others in the field to do the same. 

He said, ”I don't want to be responsible for someone becoming addicted to opioids. I personally think we can cut opioid prescribing in dentistry to less than half of what we do now."

Please read our comment policy. - The Fix
Disqus comments
Kelly Burch Contrib.jpg

Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.

Disqus comments