Policy Changes Lead to Fewer Opioid Scripts

While all eyes are on the COVID-19 pandemic, the national epidemic of opioid addiction has not gone away and may have worsened. According to new provisional data released in December by the U.S. Centers for Disease Control and Prevention (CDC), more than 81,000 drug overdose deaths occurred in the United States in the 12 months ending in May 2020. That is the highest number of overdose deaths the CDC has ever recorded in a 12-month period.¹

Curbing the opioid crisis requires effective treatment and preventive efforts. One important preventive measure is minimizing the use of opioids for pain that can be controlled by other means. This includes pain from nonsurgical dental care, such as restorative procedures. Data show that between 2010 and 2015, nearly a third of opioids prescribed by dentists were for pain from nonsurgical treatment.² Yet research also shows nonsurgical pain can often be controlled without opioids and the associated risks of addiction and overdose that opioids bring.^3,4

But there is progress. For example, a study of patients being treated under TennCare (Tennessee’s Medicaid program) found a 35% reduction in opioid prescriptions after the state limited the number of days and amount of opioid pain relievers that could be prescribed. The study also noted declines in higher-dose prescriptions, as well as opioid scripts for pain from nonsurgical care.⁵

This is a promising finding for other states looking to reduce exposure to opioids that could lead to addiction and overdose deaths. It also underscores dentists’ ability to address the opioid crisis by using non-opioid pain management strategies.

REFERENCES

1. U.S. Centers for Disease Control and Prevention. Overdose Deaths Accelerating During COVID-19. Available at: https:/​/​www.cdc.gov/​media/​releases/​2020/​p1218-overdose-deaths-covid-19.html. Accessed December 19, 2020.
2. Gupta N, Vujicic M, Blatz A. Opioid prescribing practices from 2010 through 2015 among dentists in the United States. J Am Dent Assoc. 2018;149:237–245.
3. Daniels SE, Goulder MA, Aspley S, Reader S. A randomised, five-parallel-group, placebo-controlled trial comparing the efficacy and tolerability of analgesic combinations including a novel single-tablet combination of ibuprofen/​paracetamol for postoperative dental pain. Pain. 2011;152:632–642.
4. Moore PA, Ziegler KM, Lipman RD, Aminoshariae A, Carrasco-Labra A, Mariotti A. Benefits and harms associated with analgesic medications used in the management of acute dental pain: an overview of systematic reviews. J Am Dent Assoc. 2018;149:256–265.e3.
5. DentaQuest Partnership for Oral Health Advancement. New report shows TennCare policy changes greatly reduced opioid prescriptions issued by Tennessee dentists. Available at: https:/​/​www.globenewswire.com/​news-release/​2020/​12/​08/​2141507/​0/​en/​New-Report-Shows-TennCare-Policy-Changes-Greatly-Reduced-Opioid-Prescriptions-Issued-by-Tennessee-Dentists.html. Accessed December 19, 2020.

From Decisions in Dentistry. January 2021;7(1):46.