Oral Surgeons Address the Opioid Crisis

Recently opioid abuse and addiction have been a hot story in the news. Dentists were made an early scape goat for prescribing problems with opioids. The truth is that Dentists were identified in questionnaires as being one of the earliest prescriptions for opioids that addicts were exposed to. This may be true. But Dentists write out many thousands of prescriptions for opioids every year and we only see a tiny segment of that population actually having a problem with them. There is a decision that has to be made to abuse prescriptions. And a decision has to be made to take that further and become an addict. I submit that these same individuals were likely to become abusers and addicts, either through their social experiences or by virtue of their genetic / personality predisposition, even without the dental prescription experience.  We can discuss and debate these points.  The truth is that addiction is a complicated process that exists all over the world – whether there is dental care or not.

I was trained about 30 years ago and, oral and maxillofacial surgeons as a specialty, over those years have always stressed high standards for prescribing. This is stressed regularly at our meetings both locally and nationally. We have practiced that here at our office. Over time we have studied and modified our prescribing practices with a goal to provide appropriate coverage for pain and attention to watching out for prescribing problems. The fact is that we perform procedures that cause pain.  Pain control and pain relief are expected by patients as part of quality care and we take it very seriously. We partner with the patient’s physician, healthcare providers and pharmacists in providing proper guidance in the taking of all medications. We employ pain management specialists when we feel it is appropriate.

To stay in front of this subject, our oral surgery association (AAOMS) has published a “white paper” addressing the prescribing of opioids by members of our specialty.  This paper outlines recommended prescribing practices.   In our practice we stand by this paper.  If you have an interest in this subject I encourage you to read this.