The misuse and over-prescription of opioids have contributed to the ongoing opioid epidemic, causing serious public health concerns. While dental surgeries can be a potential source of unused prescription opioids, it is essential to notice that the issue is not specific to dental surgeries alone. Various healthcare settings, including general medicine and orthopaedic practices, have also been implicated in over-prescribing opioids. Unused prescription opioids can indeed contribute to the opioid epidemic if they are not properly managed and disposed of.
Patients who receive prescriptions for postoperative pain management may not utilize the entire supply of opioids, leaving excess medication available for potential misuse or diversion. This can occur when leftover drugs are shared with family members or mates who may not have a legitimate medical need for them. Anyone who takes prescribed opioids can become addicted to them. Once addicted, it can be challenging to control. Too many prescription opioids can control a person’s breathing, leading to death. Dentistry, though seemingly unrelated, has its connection to the opioid crisis, as excess medication prescribed for postoperative pain management has the potential to fall into the wrong hands.
The Dental Prescription Dilemma:
After dental surgeries such as tooth extractions, root canals, or dental implants, it is common for dentists to prescribe opioids to manage pain during the recovery period. Opioids like hydrocodone, oxycodone, and codeine are effective painkillers but carry a high risk of misuse, addiction, and overdose. Dentists have traditionally played a significant role in prescribing opioids, with studies indicating that they are among the leading prescribers of these medications.
The Problem Of Unused Prescriptions:
One of the major concerns associated with dental prescriptions is the issue of unused medication. Patients often receive prescriptions for more opioids than they need to manage postoperative pain. This surplus of drugs increases the likelihood of excess pills being left unused, creating an opportunity for diversion and misuse. Studies have revealed that a substantial portion of prescribed opioids goes unused, with patients keeping them in their homes, leading to a potential supply of drugs for non-medical use.
Unintentional Contributors To The Opioid Epidemic:
The accumulation of unused prescription opioids is concerning because they can easily fall into the wrong hands. Family members, friends, or even acquaintances with access to these medications may be tempted to misuse them for non-medical purposes. Furthermore, unused opioids are susceptible to theft, putting them on the black market and making them available to those seeking illicit drugs. The unintentional contribution of dental prescriptions to the opioid epidemic is rooted in the failure to manage and dispose of unused medication properly.
Measures To Control Opioid Epidemic:
To address this issue, efforts have been made to raise awareness among healthcare providers about appropriate opioid prescribing practices. Dental professionals, in particular, have been encouraged to consider non-opioid alternatives for pain management whenever possible and to limit the number of opioids prescribed. Additionally, patients are being educated about the risks of opioid misuse and the importance of properly disposing of any unused medications. Some measures that can help mitigate the contribution of unused dental surgery prescriptions to the opioid epidemic include:
Prescription Monitoring Programs:
Implementing and utilizing prescription drug monitoring programs (PDMPs) can help healthcare providers identify patients receiving multiple opioid prescriptions from different sources. Implementing and strengthening these programs can help identify individuals at risk of addiction or doctor shopping (obtaining numerous prescriptions from different providers), allowing for early intervention and appropriate treatment.
Education And Awareness:
Dentists and healthcare providers can educate patients about the risks of opioid misuse, proper pain management techniques, and safe medication disposal methods. It also includes educating healthcare providers, patients, and the general public about the appropriate use of opioids, signs of addiction, and available treatment options.
Increasing access to non-opioid pain management options, such as physical therapy, cognitive-behavioural therapy, acupuncture, and non-opioid medications, can help reduce the reliance on opioids for pain treatment.
Improved Prescription Practices:
Healthcare providers should follow evidence-based guidelines for opioid prescribing, including carefully assessing patients’ pain levels and considering alternative pain management strategies before prescribing opioids. Implementing prescription limits, dosage restrictions, and mandatory use of electronic prescribing systems can also help reduce excessive opioid prescribing.
Expansion of Treatment Options:
Expanding access to evidence-based treatment for opioid use disorder, such as medication-assisted treatment (MAT), is critical. MAT combines medications like methadone, buprenorphine, or naltrexone with counselling and behavioural therapies, providing a comprehensive approach to recovery.
Support for Recovery and Harm Reduction:
Providing resources and support for individuals in recovery, including access to counselling, support groups, employment assistance, and housing, is essential. Harm reduction strategies, such as needle exchange programs and safe injection sites, can help reduce the transmission of blood-borne infections and provide opportunities for engagement with healthcare services.
Research and Surveillance:
Continued research and surveillance are necessary to understand the evolving nature of the opioid epidemic, identify emerging trends, and evaluate the effectiveness of interventions. This can inform evidence-based policymaking and targeted interventions.
Collaboration and Coordination:
Addressing the opioid epidemic requires collaboration among various stakeholders, including healthcare providers, public health agencies, law enforcement, policymakers, community organizations, and individuals with lived experience. Coordinated efforts at the local, state and national levels can maximize the impact of interventions and ensure a comprehensive response.
The opioid epidemic is a complex public health crisis that demands a multifaceted approach to find a solution. Addressing the issue of unused dental surgery prescriptions is a vital component of mitigating the opioid crisis. By minimizing the quantity of opioids prescribed, increasing education and awareness among patients, and promoting safe medication disposal, the dental community can play a pivotal role in preventing unused prescriptions from fueling the epidemic.
It is essential for dental professionals, policymakers, and the public to work collaboratively to find innovative and sustainable solutions. By doing so, we can help ensure that dental care contributes to patients’ well-being without inadvertently perpetuating the opioid crisis that continues to devastate lives and communities worldwide.