Pennsylvania dentists are among the latest to join the fight against prescription painkillers, being urged to exercise caution in prescribing highly addictive opioids to patients.
Opioids are strong pain relievers that include medications like Vicodin, OxyContin, Percocet and Avinza, and are commonly used in medical situations involving high levels of pain, including dental procedures, according to the National Institute on Drug Abuse.
The Departments of Drug and Alcohol Programs and Health released a new set of guidelines June 15 with the hopes of reducing opioid and heroin addiction in Pennsylvania. This is the third set of prescribing guidelines released by the state and is specific to dentists. Guidelines that preceded this set were specific to doctors and emergency departments, respectively.
There have been no guidelines issued for pharmacists, said Carey Miller, the press secretary for the drug and alcohol programs.
“This is a national problem,” Ms. Miller said. “About 80 percent of heroin users started with prescription drugs. This is why we are doing what we can to offer alternatives and solutions other than prescribing opioids to patients.”
Pennsylvania, hand-in-hand with the rest of the United States, has seen an increase in opioid prescription over the past 15 years, Gary Tennis, secretary for drug and alcohol programs, said in a news release. Mr. Tennis added that he believed this is directly correlated with increased heroin and opioid addiction.
“Overdose is the leading cause of death in Pennsylvania,” Ms. Miller said. “One in four families struggle with addiction.”
Ms. Miller explained that opioids, the top painkiller prescribed in the United States and one used often to combat head or oral-facial pain in dental situations, are highly addictive. People become addicted and, once they run out of pills and medical options, oftentimes turn to heroin as a cheaper alternative.
“Making sure prescription drugs are not being overprescribed is a necessary first step in curtailing drug addition and curbing the supply of excess drugs that can be used illicitly,” said Wes Culp, the deputy press secretary for the Department of Health.
According to the new guidelines, which are available online on the Pennsylvania Dental Association’s website, if opioids are to be prescribed in a dental situation, doctors must first take into consideration a patient’s past substance use and their psychiatric status. The guidelines warn against prescribing opioids in excess, stating that small amounts should only be prescribed for short periods of time, if possible, and only for severe pain.
The guidelines also recommend that dentists employ other techniques to dull pain, including local anesthetic techniques and administering non-steroidal anti-inflammatory drugs (NSAIDS) as a first resort. NSAIDS include drugs like aspirin and ibuprofen.
“NSAIDS have been demonstrated to be very effective for the treatment of dental pain, and indeed are often more effective than opioids,” the document reads.
Ms. Miller said a lot of alternatives to pain management medication are available and helpful, including physical therapy.
There have been enough prescriptions written for opioids in the U.S., she said, to give every adult a bottle of pills.
The reaction has been good, she said, from the medical society, dental association and emergency services, who were all partners in creating the guidelines. The dental association could not be reached for comment.
Patients who rely on opioids for pain relief don’t necessarily need to be worried — doctors, dentists and emergency departments will still be able to prescribe the painkillers if they’re needed. These new guidelines were put in place to encourage alternative treatments, if possible.
For those who are addicted, Ms. Miller pointed to resources her department has for those struggling, including a hotline — 717-783-8200 — care provider search and drug take-back program, all available on the department’s Get Help Now website.
Ms. Miller said that in these ways, the department is doing what they can with these guidelines to help eliminate a national issue.
“No one sets out to become addicted to opioids,” she said. “These guidelines are a small step toward decreasing the heroin and opioid crisis in Pennsylvania.”
Anicka Slachta: email@example.com or 412-263-1525.