Dentists may be over prescribing opioids


17.-Dentists-may-be-over-prescribing-opioidsA new study in the US has found that dentists are not only prescribing the use of opioids for too long after a tooth extraction, but that they are also prescribing too many tablets.

The study’s co-author, associate professor of anaesthesia Brian Bateman from Harvard Medical School, told Pain Medicine News that dentists are neglecting to consider the dangers of over prescribing opioids. The study found large numbers of patients—42 per cent—were taking high doses of opioids regardless of the possibility of addiction.

“The reason a lot of people go to the dentist is because they have pain or they undergo a procedure that causes some pain, for which the dentists are responding.

“But I believe we have gotten away from thinking about opioids as dangerous medications. Dentists may not be as conservative as they need to be with respect to using these medications, and reserving them only for patients with truly severe pain for which other treatment approaches are not adequate.”

The study turned up some concerning results, finding that the average amount of prescribed opioids was 24 pills each containing 5mg of hydrocodone–a controlled substance in Australia—“so half of the patients are getting more than that,” said A/Prof Bateman. “For patients taking four tablets a day, that is about a one-week supply, which I think for most cases is too long.”

Dr Bateman recommended that in cases where pain truly was severe then opioids should be limited to very low doses over very short periods of time. Especially as 61 per cent of adolescents in the study had filled prescriptions for opiods.

“Certainly when medications are prescribed in excess of what patients actually need, it creates leftover pills, which we know is a major source for opioids that are misused or diverted,” he said. Dentists “need to re-evaluate the indications for prescribing opioids.”

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