American society is finally coming around to the fact that deadly opioid misuse is not something that is only experienced by hardened, down-and-out people without families or support networks. Substance abuse – especially opioid abuse – can start innocently and does not discriminate based on age, profession, sex, race, or any other demographic label.
While you may see the end results of opioid abuse in sad news segments, in truth you may be seeing substance abuse in your everyday life, among people you know and love. Substance abuse and addiction can easily begin after routine medical services, including dental procedures.
Dentists Prescribe Significant Amounts of Opioids
Dental procedures can be painful, and people often see their dentists precisely because they are in pain, so there is nothing surprising about the fact that dentists must help their patients manage pain. Twelve percent of prescriptions for immediate-release opioids are written by dentists, and dentists are in the top-four ranked medical specialties for opioid prescription rates.
Nearly one-quarter of all prescribed doses of opioids are used in ways other than directed, and because of the very real need dentists have to prescribe pain medications, some people with substance abuse issues seek out dentists specifically. Yet only a small proportion of dentists participate in substance abuse mitigation efforts like prescription drug monitoring programs.
Changing the Dental School Curriculum in Light of the Opioid Abuse Epidemic
Slowly, dental schools are beginning to place greater emphasis on preventing, recognizing, and referring cases of substance abuse among dental patients. In some cases, these curricular additions result from the personal experiences of dentists with the ravaging effects of substance abuse. Dr. Omar Abubaker, an oral surgeon and professor at Virginia Commonwealth University’s dental school, has made substance abuse education a priority for his students after having lost one of his adult children to a heroin overdose.
Dental schools in Massachusetts are now required to teach core competencies on non-opioid pain relief options and must demonstrate a knowledge of exactly when opioid prescriptions are called for and when non-opioid pain relief is the prudent choice.
Dentists and other practitioners have been criticized in the past for not doing enough to help patients control pain, and as a result, many became more liberal with their opioid prescribing habits. Now, the tide is turning the other way. Dentists must walk the fine line of managing patients’ pain without unnecessarily exposing them to substance abuse risk, and it is not always easy.
Should Dentists Screen for Substance Abuse?
Some addiction specialists believe that, like other medical specialists, dentists should screen their patients for substance misuse, both through careful medical histories and by implementing screening programs to learn if patients are already abusing opioids and are taking prescribed opioids as directed. While the majority of US dentists report querying patients about substance abuse, fewer than half go as far as screening patients for opioid misuse. Only 38 percent reported having accessed a prescription drug monitoring program to mitigate the risk of substance abuse among patients.
Education Must Underpin All Risk Management Strategies
With a problem as huge and multidimensional as opioid addiction, no single risk mitigation strategy will be enough to make a significant difference. In fact, dentists and all other practitioners authorized to prescribe opioids will have to address the problem from several angles.
First, they must educate themselves about the true nature of opioid addiction and the extent of the problem in America. They may learn this in newly updated dental school curricula, or through continuing education or professional association events. Additionally, they must take careful medical histories to try to learn of previous substance abuse problems. It would also be good to consider either screening patients taking opioids, using a prescription drug monitoring program, or both.
Dentists want to do what is right and prevent their patients from unnecessary pain and suffering. Yet they must also be aware of the risks involved with prescribing opioid pain relievers and be more willing to prescribe non-opioid pain medications where appropriate. Unfortunately, routine dental procedures can lead to the scourge of opioid addiction, and recovery requires a patient-centered, individualized addiction recovery program. If you have become ensnared in the trap of opioid addiction, there is hope, and we invite and encourage you to contact us at any time to learn more about how to start your successful recovery.
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