The Practicon Viewpoint by Ann Page Griffin

A NATIONAL EMERGENCY

In August 2017, President Trump declared opioid abuse a national emergency and ordered the President’s Commission on Combating Drug Addiction and the Opioid Crisis to use all necessary crisis management measures and authorities to combat the nationwide emergency. By late October of this year, the President broadened the declaration to define it as a Public Health crisis. The Public Health designation means there will be expanded access to telemedicine services for rural and remote residents. In addition, officials will be able to deploy state and federal workers more easily to assist with the crisis, obtain grants from the Department of Labor, and move funding for HIV and AIDS programs to provide more substance abuse treatment.

The statistics from the President’s Commission are appalling. Between 1999 and 2015, more than 560,000 Americans died of drug overdoses. In 2015, nearly two-thirds of drug overdoses were linked to opioids like Percocet, Oxycontin, heroin, and fentanyl. The overdose rate nationwide currently stands at 142 people per day.

The American Dental Association has joined the battle, requesting that the FDA (Food and Drug Administration) focus on better opioid prescriber education and training programs dealing with the nuances of managing dental pain. Specifically, the ADA has requested that FDA training materials for opioid prescribers be expanded to include education about immediate-release, short-acting opioids for management of acute pain following one-time dental procedures. Rarely, if ever, does a dentist prescribe extended-release, long-acting opioids to manage chronic pain. However, the current federal education program and training materials for prescribers do not sufficiently address the differences between a prescription for immediate-release, short-acting opioids for acute pain vs extended-release, long-acting opioids for chronic pain. The ADA has also requested that the FDA develop a risk management program for dentists to include the choice of non-opioid alternatives for the management of acute dental pain and methods used to identify patients at risk of abusing opioids.

While waiting for the FDA to respond to the ADA requests with new programs and training materials, dentists can educate themselves about the nuances of opioid prescription, the horrors of opioid abuse, and ways to alert patients to the dangers of long-term addiction with a series of ADA-produced webinars with titles such as: Opioid Prescribing in Dental Medicine, Reducing Opioid Abuse, and Preventing Prescription Opioid Diversion. The webinars are available on the ADA Center for Professional Success website (you will need the latest version of Adobe Flash to view the webinars).