When covering the opioid epidemic, don’t forget the dental angle

Mary Otto

About Mary Otto

Mary Otto, a Washington, D.C.-based freelancer, is AHCJ's topic leader on oral health and the author of "Teeth: The Story of Beauty, Inequality, and the Struggle for Oral Health in America." She can be reached at mary@healthjournalism.org.

Photo: ^Thais^ via Flickr

President Donald Trump’s decision to declare opioid addiction a national emergency could be at least a step toward addressing the complex crisis blamed for claiming more than 33,000 lives in 2015.

The emergency declaration potentially could be used to expedite state responses, dispatch U.S. Public Health Service personnel to hard-hit communities and step up requirements for prescriber education, according to Andrew Kolodny, co-director of opioid policy research at Brandeis University’s Heller School for Social Policy and Management, who was interviewed for a Washington Post story.

“There’s a lot that could be done,” Kolodny said. “It could be very helpful, much more than just symbolic.”

The declaration was among several recommendations in an interim report by the White House Commission on Combating Drug Addiction and the Opioid Crisis led by New Jersey Governor Chris Christie.

The commission called on the Trump administration to increase treatment capacity and medication-assisted treatment programs across the country. The panel stressed that medical and dental schools should be enlisted to assist mandated prescriber education initiatives to help ensure physicians, dentists and other providers are more aware the risk in over prescribing opioids.

“While we acknowledge that some of this inappropriate overprescribing is done illegally and for profit, we believe the overwhelming percentage is due to a lack of education on these issues in our nation’s medical and dental schools and a dearth of continuing medical education for practicing clinicians,” the report said.

Dentists are among the leading prescribers of opioid pain medications in the country, according to numerous studies. The prescriptions often are written for patients after tooth extractions – including approximately 3 million mostly young adults who have wisdom teeth extracted each year. Tina Rosenberg recently explored that specific trend in a recent Fixes column for the New York Times.

“We set young people on the course of misuse and addiction.” Harold Tu, director of the division of oral and maxillofacial surgery at the University of Minnesota School of Dentistry, told Rosenberg, who noted in her story that dentists and oral surgeons are considered among the most frequent prescribers of opioids for young people ages 10 to 19.

“That’s an age when the growing brain, which doesn’t mature until 25, is particularly susceptible to being taken over by opioids — even if the dosage seems too small to produce addiction,” she noted.

Under Tu’s leadership, the Minnesota dental school instituted a mandatory protocol last year that made nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, combined with acetaminophen, the first-line pain treatment for dental procedures.

“The department is gathering data to present scientifically about how patients are doing,” Tu told Rosenberg. “But anecdotally, we have not seen an increase in patient complaints or patients returning saying ‘the NSAIDs are not working; I need something stronger.”

So when covering the nation’s opioid epidemic, don’t forget the dental angle. Here is an AHCJ tip sheet with additional resources that might help.

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