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The Role of Dentistry in Prescribing Opioids
In the recent months and years, the rise of opioid abuse and addiction has caused major concern among health care professionals and is now being addressed by legislators and the Governor's Administration. While this has become an epidemic across the United States, Pennsylvania is one of the 20 states with a higher rate of drug overdoses than the national average. According to a recent study by University of Pittsburgh Graduate School of Public Health, "Fatal drug overdoses in Pennsylvania increased 14-fold between 1979 and 2014 with the highest rates among females, white people and those between the ages of 35 and 44."
Dentists are finding themselves at the forefront of this issue, due to the prescription of opioids that are often given to patients who have wisdom teeth removed or other involved dental surgery. Opioids are a class of drugs that include powerful pain relievers such as oxycontin, oxycodone, hydrocodone, fentanyl and codeine.
Dr. Joel Funari, PDA member dentist from Devon and Diplomate of the American Board of Oral and Maxillofacial Surgery, says that some of these drug addictions can be traced back to a person's trip to the dentist.
"Young people typically have their first exposure to opioids after wisdom teeth removal, minor surgical procedures or after athletic injuries," Dr. Funari said. "Additionally, unused narcotic prescription pills left in the house are targets for use by other family members or resold on the street due to their high value. Once addicted to prescription narcotics, individuals often turn to heroin and cocaine use when the narcotic prescriptions become too expensive or unavailable. This is a big reason why prescription opioids are being taken very seriously, since they are often a gateway to more dangerous drugs."
While dentists have a significant role in prescribing these medications, it's important to remember that this is just one piece of a much larger picture. A 2014 article from Pain Research and Management indicated that only 4-8 percent of opioid prescribing came from dentists. However, dentists prescribe pain relievers at a higher rate than some other health care providers because of the nature of their treatment and the procedures they perform.
To help address this growing issue, the American Dental Association (ADA) provides multiple resources for assisting dentists and patients. ADA is hosting free continuing education webinars on practicing safe opioid prescribing. Most states also have a prescription drug monitoring program (PDMP) to determine whether a patient may be "doctor shopping" based on their prescription history. For a preventative approach, dentists can guide patients to visit www.mouthhealthy.org/meds so they are aware of the dangers of using opioid pain medications for non-medical purposes.
The Pennsylvania Department of Health (DOH) Committee on Prescriber Practices, on which Dr. Funari serves as a consultant, has developed specific guidelines on the prescription of opioids for medical and dental specialties. In addition, the state is implementing a new PDMP.
On the legislative front, Pennsylvania lawmakers are working on a bill that will require continuing education in opioid addiction. Rep. Kurt Masser and Sen. Gene Yaw introduced legislation, which would require professional licensees, including dentists, to obtain initial training and continuing education in opioid treatment and addiction. A continuing collaboration of efforts from health care providers, legislators and patient's families will be needed to curb opioid abuse.
About the Pennsylvania Dental Association
Founded in 1868, the Pennsylvania Dental Association (PDA) is comprised of approximately 6,000 member dentists. It is a constituency of the American Dental Association (ADA), the largest and oldest national dental society in the world. PDA's mission is to improve the public health, promote the art and science of dentistry and represent the interests of its member dentists and their patients. PDA is the voice of dentistry in Pennsylvania. For more information on PDA, visit our website at www.padental.org.
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