|
 Moreover, the types of opioids prescribed by U.S. dentists are more
likely to be those "with a high potential for abuse, such as
oxycodone," researchers reported in JAMA Network Open.
"Dentists are one of the top prescribers of opioids, second only to
family physicians" said lead study author Katie Suda, an associate
professor of pharmacy at the University of Illinois, at Chicago,
College of Pharmacy. "If you look at what prescription medications
dentists are prescribing, opioids are the second most frequent,
after antibiotics."
Studies have shown that even as opioid prescribing rates have been
declining overall, dental prescribing rates have been on the rise,
Suda and her colleagues noted. And that's despite the fact that
there's research proving that non-opioid analgesics are just as
effective as opioids in controlling dental pain, Suda said.
"In our study, we found that one in 10 of the opioids (prescriptions
from) U.S. dentists are for high potency opioids whereas dentists in
England didn't prescribe any of them," Suda said. "The English model
is very different. There are guidelines available that are specific
about the treatment of oral pain. They recommend as the first line
of therapy non-opioid analgesics: their version of acetaminophen and
an NSAID."
To take a closer look at the opioid prescribing patterns of U.S.
dentists, Suda and her colleagues turned to two databases. Data for
U.S. dentists came from IQVIA LRx, which contains data for 85
percent of all outpatient prescriptions and includes those written
for patients covered by commercial insurers, Medicare and Medicaid.
Data for English dentists came from the NHS Digital Prescription
Cost Analysis and included 84 percent of the UK population.
In 2016, U.S. dentists wrote more than 11.4 million opioid
prescriptions, while English dentists wrote 28,082 prescriptions for
the drugs. The proportion of all dental prescriptions written for
opioids was 37 times greater in the U.S. than in England.
Moreover, dentists in the U.S. wrote opioid prescriptions at a rate
that was more than 70 times that of their English counterparts: U.S.
dentists wrote 35.4 opioid prescriptions per 1,000 Americans, while
English dentists wrote 0.5 opioid prescriptions per 1,000 British.
[to top of second column] |
While there has been a lot of attention paid to opioid prescribing
by other health professionals, "few public health efforts have
focused on dental providers," Suda said. "We were surprised by the
magnitude of the difference."
Dr. Joel Hudgins, who recently authored a study on opioid
prescriptions written by ER doctors for adolescents and young
adults, said he was struck by the size of the difference between
English and American dentists. "The metric that matters, U.S.
dentists prescribing opioids at a rate that was 70 times that of
English dentists, may be a marker for how much opioids are getting
into the population," said Hudgins, a clinical instructor at Boston
Children's Hospital and Harvard Medical School.
Intriguingly, the results from the new study did fall in line with a
finding from Hudgins' study: ER doctors had prescribed opioids to
nearly 60 percent of their young patients with dental complaints.
Dr. Michael Lynch suspects that similar differences in opioid
prescribing would be seen if other specialties were compared.
"It's clear that too much opioids are being prescribed and we want
to make sure to reduce the rate responsibly, while making sure pain
is adequately treated," said Lynch, a toxicologist and emergency
medicine physician and medical director of the Pittsburgh Poison
Center at the University of Pittsburgh Medical Center.
Lynch noted that people should be careful to dispose of leftover
pills, so they won't be available for others to use.
SOURCE: http://bit.ly/2Ez0uID JAMA Network Open, online May 24,
2019.
[© 2019 Thomson Reuters. All rights
reserved.] Copyright 2019 Reuters. All rights reserved. This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |
