Austin, TX – All career paths and services have their key controversial issues. Some of them are a side effect of old practices, and others are a byproduct of other outside factors such as resources or policies yet to be put in place. We hold dentists to a similar standard as most medical professionals, and on some level, they still hold themselves to it. So, it would make sense that dentists would have the same conflict as other medical professionals. And a big one is the use of opioids.
Opioids
Opioids are not a newly controversial topic. This is something that has been the driving force behind 300 years of conflict. Its ancestor, opium literally caused a war in China, has been a subject behind the Temperance movement, and was the reason cough syrup killed a lot of infants in the 1920s. However, just like alcohol, opioids are still a very common sight. They are available, but they come in a different form than it did 100 years ago. The only difference between the heroin today and the painkillers doctors give us is the presentation and time period. But how do we define opioids, and what makes them such a controversial issue to begin with?
Opioids work as both a pain reliever and an anesthetic that binds to certain receptors in your brain. According to the American Association of Anesthesiologists “Opioids attach to proteins called opioid receptors on nerve cells in the brain, spinal cord, gut and other parts of the body. When this happens, the opioids block pain messages sent from the body through the spinal cord to the brain”. When used too often, it can decrease its effect over time, creating a need for increased dosage and a dependancy. This dependancy can become severe when there is enough of an euphoria to encourage a recreational use of the drug. This addiction can create a fatal overdose when not properly treated.
What Opioids are there?
While opioids get associated with the public perception of opium, as a byproduct of the poppy flower, there are plenty of opioids out on the market. Some are more severe than others, and mostly, everyone has used them at least once. You might be familiar with one or more of the opiates on the list:
- Codeine
- Fentanyl
- Hydrocodone
- Oxycodone
- Oxymorphone
- Morphine
Codeine, for instance, is something in Tylenol. All it takes is too much tylenol and you could get an addiction. If that doesn’t illustrate the scope of the problem, there are more statistics that point to it. The CDC states, that as of 2017 more than 399,000 people died from overdoses having to do with any opioid. While part of those numbers include heroin and commonly prescribed opioids, the highest death count belongs to synthetic opioids. And, on top of it 40% of those overdose deaths are a result of prescription opioid.
How Can Dentists Help with the Problem
So, what are dentists doing to help on their end curtailing the problem? While there are certainly a lot of nuanced factors, most of which is far outside their scope of expertise. However, that doesn’t mean that dentists are unable to do anything. A few of them are highlighted by the National Institute of Dental and Craniofacial Research.
- Perscription limitations: While it is impossible to avoid barring every addict access from the drugs they are looking for, you can at least make it harder.
- Prescribe the lowest effective dose of immediate-release opioids.
- Prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids.
- Note that three days or less will often be sufficient, and more than seven days will rarely be needed.
- Use alternatives: It turns out there are anti-inflammatory analgesics and other forms of anesthesia that are less addicting. The CDC provides guidelines for those.
- Counsel your Patient and Communicate :
- Ask about any other medications they’re currently taking, and whether they or any family members have had problems with substance abuse, such as with alcohol, prescription medications, or illicit drugs.
- Explain the risks of taking the medication.
- Describe how to take the medicine and how long to take it.
- Explain that alcohol should never be used when taking an opioid medication.
- Provide guidance on storing medication in a safe place out of sight and out of reach of children, preferably in a locked cabinet.
- Know your state’s regulation. They usually have guidelines and laws that set time or dosage limits.
While it may take a while, these regulations for dentists are headed in the right direction.