Background: The opioid epidemic is a serious crisis in the United States. It has been proposed that opioid prescriptions after dental procedures are a major contributor to opioid use and abuse. The American Dental Association has been working to educate dental care providers about safe opioid prescribing practices. The authors hypothesized that oral and maxillofacial surgeons, following the efforts and publications from the American Dental Association, have been prescribing fewer postoperative opioids.
Methods: This was a multi-institutional retrospective study with a total of 3,710 patients from Loma Linda University and University of Texas Health Science Center at Houston undergoing ambulatory surgical tooth extraction under general anesthesia or sedation. The total quantity of postoperative opioids (ie, morphine milligram equivalents) was analyzed during the following 2 periods: from 2011 through 2016 and from 2017 through 2021.
Results: The amount of opioids prescribed decreased significantly over time at both study institutions across all demographic characteristics and cohorts. The mean (SD) morphine milligram equivalents prescribed per patient was significantly reduced from 143.01 (71.08) in the 2011 through 2016 period to 72.09 (55.40) in the 2017 through 2021 period (P < .001).
Conclusions: The data suggested that there has been a significant decrease in the amount of opioids prescribed after ambulatory oral surgery procedures during the 10-year study period. This provides evidence that dental care providers have responded to the opioid crisis.
Practical Implications: By means of identifying opioid prescribing patterns, the authors presented an opportunity to help inform interventions and policies that promote responsible prescribing, enhance patient safety, and support optimal pain management.
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http://dx.doi.org/10.1016/j.adaj.2024.11.009 | DOI Listing |
Background: The opioid epidemic is a serious crisis in the United States. It has been proposed that opioid prescriptions after dental procedures are a major contributor to opioid use and abuse. The American Dental Association has been working to educate dental care providers about safe opioid prescribing practices.
View Article and Find Full Text PDFIowa Orthop J
January 2025
NYU Langone Orthopedic Hospital, New York, New York, USA.
Background: Optimal management of post-operative pain is a critical component of orthopedic surgical care. There is a heightened awareness of narcotic prescribing habits given the current "opioid epidemic." The lack of standardized protocols has led to increased errors, delayed access to prescribed medications, and excessive narcotic prescribing.
View Article and Find Full Text PDFJ Psychoactive Drugs
January 2025
McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Co-occurring substance use disorders are common in medical settings, yet limited literature exists on concomitant pharmacological management. We present a case where low-dose buprenorphine induction (LDBI) and rapid phenobarbital taper were performed concurrently in a hospital setting to manage co-occurring opioid dependence (on chronic methadone maintenance therapy) and benzodiazepine dependence (prescribed alprazolam). The simultaneous management was well-tolerated and completed with minimal complications, successfully enabling candidacy for the patient's preferred disposition.
View Article and Find Full Text PDFJ Oral Maxillofac Surg
December 2024
Corresponding Member of the Faculty, Harvard School of Dental Medicine, and Visiting Surgeon, Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, MA. Electronic address:
Background: Many oral and maxillofacial surgery patients are young, healthy adults who are opioid-naïve. Over-prescribing opioids increases the risk of subsequent misuse and diversion.
Purpose: The purpose of this study was to measure and compare opioid prescriptions to opioid naïve and nonnaïve patients by oral and maxillofacial surgeons in Massachusetts from 2012 to 2022.
J Am Coll Surg
January 2025
Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
Introduction: Pathway-driven, post-pancreatectomy opioid reduction interventions have proven effective and sustainable and may have a "halo effect" on other major abdominal cancer operations. This study's aim was to analyze the sequential effects of expanding opioid reduction efforts from pancreatectomy on opioids prescribed after hepatectomy.
Methods: This is a retrospective cohort study utilizing data from the electronic health record and a prospective quality improvement database for consecutive hepatectomy patients (09/2016-02/2024).
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