RelatedSurvey: At least 23 percent of New Englanders know someone with an opioid addiction
A Stanford University study published in JAMA Internal Medicine documents the negative impact of these prescriptions: "Of nearly 15,000 young people who received initial opioid prescriptions from their dentists in 2015, 6.8 percent had additional opioids prescribed between 90 and 365 days later, and 5.8 percent were diagnosed with opioid abuse during the 12 months after the initial prescription. In a comparison group that did not receive an opioid prescription from their dentists, 0.1 percent got another opioid prescription, and 0.4 percent were diagnosed with opioid abuse over the same period."
For some people, it takes as little as 5 days to become dependent on an opioid painkiller, and with the widespread advent of fentanyl, dependence and addiction have become more deadly. We lost more than 400 Rhode Islanders and more than 107,500 people throughout the nation to overdoses last year.
While it is essential that quality, evidence-based treatment be available to all Rhode Islanders who have opioid use disorder, the path to recovery even for people receiving quality treatment is challenging, often involves relapses, and is hit or miss in ultimate outcomes. It is far preferable to prevent dependence and addiction in the first place. This requires doing a better job of addressing it at the source, and for too many that source remains their dentist's office.
The basic state policy building blocks to do better are in place. These adopted laws and regulations include pill limits on the first prescription, mandating training in best practices in prescribing for all medical professionals licensed to prescribe opioids, requiring prescriber and patient have a crucial conversation upon first prescription of an opioid pain reliever, to warn of risks of addiction and when appropriate discuss alternative treatments, and giving patients the tools to request partial prescriptions and the right to indicate on their medical chart that they should never be prescribed an opioid.
Yet this still comes down to individual decisions by dentists and other medical practitioners, as well as by parents and patients. Here is where more public education efforts are required. These includes targeted communications directed at Rhode Island dentists, dental hygienists, dental insurers, dental clinics and other stakeholders. It is also important to get information to parents, teenagers, and young adults, so they can make informed choices.
It is time to do more to take on the opioid epidemic at one of its prime sources. The Council to Prevent Public Opioid Dependence will undertake a public education effort: Rhode Islanders working together - including health care stakeholders, dental practices and high schools - can avoid more senseless deaths and ruined lives.