The Opioid Epidemic—Are Dentists the Black Sheep?
Posted: June 23rd, 2016 | Author: Shauna | Filed under: Basics, Controlled Substances, Dental, In the News, Public Policy | Tags: American Dental Association, Controlled Substances, Dental, Dental e-Prescribing, DoseSpot, e-Prescribing, e-Prescribing controlled substances, Harvard T.H. Chan School of Public Health, Hooked, JAMA, NBC News, Opioid Epidemic, Oral Health | No Comments »Once again, the dental industry is in the hot seat regarding their perceived contribution to the opioid epidemic that the United States is currently facing. As part of their “Hooked†series, NBC News recently reported on this deadly triangle: the relationship between dentists, drugs, and dependence and how dentists are at the forefront of this crisis, even citing that they’re taking the easy way out when treating patients.
“We see it across medical and dental practices that physicians and dentists are giving patients extra medication just in case to avoid seeing the patient again or writing for refills. This is an obvious problem that leaves a lot of left over medication and patients hold on to it.” -Dr. Brian Bateman, Division of Pharmacoepidemiology and Pharmacoenocomics at Brigham and Women’s Hospital.
The article highlights a young woman’s journey from substance abuse to recovery, stating that her addiction to opioids started at her dentist’s office. She was having her wisdom teeth removed, a very common procedure among adolescents that typically warrants pain medication, but she was prescribed a 30-day supply and was not properly educated on the effects an opioid can produce. Having only experienced pain for a few days, she continued to take the medication because it made her feel invincible, powerful even, and the extra pills were just laying around. Unfortunately, this is how opioid addiction usually starts: with a prescription. Patients these days are also going to extreme lengths to obtain these substances such as doctor shopping to receive more medication, buying or selling on the black market, and sharing prescriptions with friends and family.
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Of course this isn’t the first time dentists are being victimized as the gatekeepers for these controlled substances. There has been a dramatic rate of response from organizations across the country in regards to this increasing epidemic. Senator Dick Durbin of IL recently wrote a letter to the American Dental Association (ADA), among other associations, which ultimately bashed the industry and claimed that dentists fail to take responsibility for its role contributing to the crisis and that they’re taking advantage of perceived financial incentives to over-treat pain. Likewise, articles published by JAMA and Harvard have made notion that the dental industry is a crucial piece of this epidemic puzzle.
Let’s play devil’s advocate and take a step back to evaluate what is most likely going on in dental offices. What are the pain points, exactly?
Paper prescriptions are not their friend.
Prescription pads or print-out prescriptions leave an immense amount of risk. Who’s to say a patient won’t alter the pill quantity, claim they lost their prescription, or worse, steal a prescription pad? It’s very easy to swipe a small piece of paper without anyone noticing.
They don’t know the unknown.
If a dentist doesn’t know a patient’s medication history, current medications, allergies, or any history of substance abuse, they cannot make an educated decision when it comes to what they prescribe.
They’re simply trying to do their job.
When a patient goes in for a procedure, a dentist naturally wants to make them as comfortable as possible—before, during, and post-surgery. However, prescribing opioids and at high amounts have become the norm nowadays and other alternatives, such as higher doses of acetaminophen or ibuprofen, aren’t even considered.
Luckily, e-Prescribing can mend all of these pain points, while also creating greater clinical efficiency and relieving a dentist’s anxiety for potential risk. It’s completely acceptable to not know all the answers or available resources that are out there as we combat this opioid crisis, but it’s not okay to turn a blind eye. Bottom line is: education is crucial during a time like this. Don’t remain a victim; take action and spearhead the change.
Sources: NBC News; JAMA; Harvard; Boston Globe
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