Reducing prescription painkiller abuse is a national policy objective. New research suggests education can help dentists combat, rather than contribute to, abuse of addictive painkillers.

While dentists are the third-largest source of painkiller prescriptions they often have not perceived there to be a problem, says George Kenna, Ph.D., an assistant professor of psychiatry and human behavior at Brown University.

“Dentists write the third-most prescriptions for immediate release opioids in the United States, but they often don’t know the appropriate number of doses to prescribe, how many doses a patient uses, or most importantly what patients do with the leftover tablets they have.

“Just ask someone the last time they threw away opioid prescriptions in particular. These leftover tablets — accumulated from various sources, not just dentists — that are often left in closets across the country are the primary source for prescription drug use initiation for children and adolescents.”

New federal policy is directed toward reducing the number of leftover painkillers such as hydrocodone and oxycodone that can become a supply of drugs in the home for those who would abuse them, said Kenna, who is also a pharmacist.

The National Survey on Drug Use and Health has found that seven in 10 people who have used painkillers nonmedically got the drugs through a family member or friend who had a prescription.

The July cover article for the Journal of the American Dental Association offers several recommendations for dentists including discussing with patients non-opioid painkiller options and their benefits.

Experts call for additional research to make the most effective use of opioid and non-opioid painkillers, for instance to determine how much painkiller and which kind patients really need. Without enough evidence to guide them, dentists have often felt obliged to prescribe opioids too often and in too great a quantity, Kenna said.

“Some new data show that ibuprofen as an anti-inflammatory does as well as many painkillers to kill pain for many dental procedures,” Kenna said.

For all the things dentists could do, especially with more research to clarify the best prescribing practices, Kenna acknowledged that dentists are not currently compensated for the time required to investigate the drug use preferences and habits of their patients.

Kenna said he hopes to learn more about how the profession approaches opioids and addiction with a national survey of dentists.

“It’s a growing problem in the United States,” he said. “It’s a serious problem.”

Source: Brown University