Benefits administrator blog from Delta Dental

Tag: opioids

How dentists fight opioid addiction

There’s no shortage of issues confronting the country and the world today. Alongside COVID-19 and climate change, the opioid epidemic remains a major issue in the United States. Fortunately, there are steps that dentists can take to do their part to help combat addiction and abuse.

One of the simplest but most effective steps dentists can take involves prescribing alternatives to narcotics. Studies have found that a combination of ibuprofen and acetaminophen can be a more effective pain management tool than simply prescribing opioids.

As Dr. Daniel Croley, our Vice President of Network Development, says, “We ask that all dentists consider non-addictive pain management as their first choice. When narcotics are needed, only prescribe the lowest dosage and quantity needed to effectively manage your patients’ pain.”

In honor of National Recovery Month, Delta Dental has launched an informational campaign to encourage dentists to educate themselves and their staff about the opioid epidemic. This includes letters sent directly to dentists, educational blog posts on the topic and new opioid-focused material in webinars.

We also encourage dentists to:

  • Stay on top of the latest developments in pain management
  • Talk openly and honestly with patients about their history before prescribing opioids
  • Follow ADA guidelines, which include education about opioids, limits on prescriptions, and drug monitoring

In the words of Dr. Croley, “Together, we can stop the overprescription and abuse of opioids.”

Dentistry’s role in the U.S. opioid epidemic

If you’re reading this, chances are you’re well aware that Americans are struggling with the effects of a nationwide opioid epidemic. In fact, as of 2017, the Centers for Disease Control and Prevention (CDC) estimated that, on average, 115 Americans die every day from an opioid overdose.

But if you’re not following the storyline closely, you may not be aware of some of the risks. Here are some steps organizations, businesses and providers are taking to combat the epidemic.

Recognizing the issue and identifying risk factors

In the face of the epidemic, one of the first responses is both natural and logical — how and why is this happening? Unfortunately, dentists have been linked to the epidemic as a major prescriber of opioids for people ages 10 to 19. (This is typically when people have their wisdom teeth removed.)

Research shows that first-time opioid users show an alarming probability for continuing use. One study revealed that patients in this population who were prescribed a 12-day supply of opioids face a 25% probability of continuing use a year later.

Therefore, it’s crucial to monitor and carefully consider patients’ exposure to these drugs to prevent illicit use. We recognize that dentists, in particular, are faced with the dilemma of treating pain effectively and responsibly. And sometimes the methodology isn’t so clear.

A breakthrough in pain management research

Fortunately, research has shown that opioids are not the only effective course of treating post-operative (and non-surgical) dental pain. In fact, opioids may not even be the most effective treatment in these cases.

A 2018 study published in the Journal of the American Dental Association revealed two crucial things about treating severe dental pain:

  • Combinations of ibuprofen and acetaminophen had the highest proportion of adult patients who experienced maximum pain relief
  • Treatments that included opioids were among those associated most frequently with severe adverse events in both children and adults

With this knowledge, prescribers are better suited to determine and follow guidelines when treating patients with severe pain.

What we’re doing at Delta Dental to combat addiction

The Delta Dental Plans Association has stated our national system’s position on opioid prescriptions as follows:

Although Delta Dental does not cover prescriptions, including opioids, we are maximizing our unique role of having 75 percent of the nation’s  dentists in our provider network to be an actively engaged voice and  partner in the fight against opioid misuse.

Within our Delta Dental enterprise, we’re engaging our providers, clients and enrollees by sharing resources and continuing a dialogue of awareness and prevention.

We urge our providers to follow best practices in treating acute pain, including:

  • Considering alternative treatments to opioids, like nonsteroidal anti-inflammatory drugs (NSAIDs), acetaminophen or a combination of these drugs when possible.
  • Conducting a thorough medical and dental history when considering prescribing opioids.
  • Considering treatment options that prevent exacerbation of, or relapse of, opioid misuse.
  • Following CDC guidelines for dosage and duration of prescriptions, including prescribing the lowest possible effective dosage and staring with immediate-release opioids instead of extended-release/long-acting opioids.

For our clients and enrollees, we provide several wellness resources in the oral health section of our website, including a guide for parents of teens who could be prescribed pain medication.

Steps employer groups can take to make an impact

If you’re looking for ways to engage your workforce about responsible opioid use, there are a number of things you can do. And as if you need any further incentive to take action, the Kaiser Family Foundation recently revealed that from 2004 to 2016, employers are spending nearly nine times more to treat opioid addiction and overdoses.

Deloitte’s Center for Health Solutions covers this rise in health care costs in a recent article, and suggests the following steps to take action:

  • Creating drug-free workplace policies
  • Increasing communication
  • Identifying at-risk employees
  • Covering treatment therapy
  • Treating workers for addiction, rather than terminating them
  • Working with health plans and pharmacy benefit managers (PBMs) to find solutions

For inspiration, check out how the Boeing Company took a proactive approach to combating addiction — including mailing letters to patients and prescribing physicians making them aware of the potential risks involved with the drugs.

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