The impact of a PDMP in opioid prescribing and monitoring depends on the state in which a dental practitioner lives. Moreover, as new programs are introduced and others evolve, PDMP regulations change and must be monitored by practitioners. State-specific information on topics related to Prevention The first step in prevention is awareness of the problem. Educating the dental team and keeping abreast of new information and available resources related to the prescription drug crisis can provide appropriate strategies for prevention. Part of this awareness is understanding the populations most at risk for abuse: teens (particularly females), college students, the military, Native Americans, Alaska Natives, the elderly, individuals with comorbidities (coexisting physical, mental, or behavioral conditions), and patients with a previous or family history of substance abuse. Being aware that family and friends are the most common source of prescription drug use allows the dental team to educate their patients when opioid pain relievers are prescribed. Informing patients and families of the abuse potential of these drugs and alerting them to the need for safe, locked storage of the medication can help the family recognize possible abuse and prevent diversion from the drug’s intended patient and use. When a patient presents with pain, the informed dental practitioner can consider the use of NSAIDs and APAP as first- line pain management, whether alone or in combination, when not otherwise contraindicated. Patients need to be instructed Conclusion This course has provided an overview of the escalating problem of prescription drug abuse in the United States. The opioid drugs have been given specific attention because they are the prescription drugs most commonly abused and most relevant to the dental practitioner treating dental pain. The role of the dentist and dental healthcare team in identifying and preventing the misuse, abuse, and diversion of prescription drugs is critical for curbing this national epidemic. More research is needed into pharmacologic alternatives, prescribing patterns of dentists and other healthcare providers, public understanding and awareness, and more effective The American Dental Association’s website provides information for dental professionals on the abuse of prescription drugs. It provides current ADA policies, statements, and guidelines, as well as additional resources for both the public and dental professionals. Website: https://www.ada.org/en/advocacy/advocacy-issues/opioid- crisis Centers for Disease Control and Prevention CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016 The CDC issued these recommendations in response to the epidemic of deaths from opioid overdose. Website: https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm Commissioned Corps of the U.S. Public Health Service, Pharmacist Professional Advisory Committee Clinical Collaborative Practice Agreements: Critical Elements in Designing a Collaborative Practice Agreement (CPA)/Clinical Protocol. This committee provides information regarding critical elements and clinical guidelines for establishing collaborative practice agreements (CPAs). Website: https://dcp.psc.gov/osg/pharmacy/cpharm_cguide_cpa.aspx National Coalition Against Prescription Drug Abuse (NCAPDA) The National Coalition Against Prescription Drug Abuse (NCAPDA) is a resource created to raise awareness of the dangers caused by prescription drug abuse. The NCAPDA website targets individuals at risk for prescription drug abuse and their families and provides links to resources including community programs and drug abuse hotlines. This organization also offers downloadable educational tools for raising awareness of prescription drug abuse. Website: https://ncapda.org Resources American Dental Association (ADA)
PDMPs is primarily available from the National Alliance for Model State Drug Laws (NAMSDL; https://namsdl.org) and the National Alliance of State Controlled Substances Authorities (NASCSA; http://www.nascsa.org).
on the safe use of these medications and understand that pain that persists longer than a few days needs to be re-evaluated in the dental office. If opioids are indicated, limiting quantities to what is needed for only a few days and providing appropriate patient education will help to prevent a new abuse problem from occurring. Known or suspected drug abusers should not be prescribed opioid pain medication; consultation with their physician or pharmacist can alert other healthcare providers of the problem and set the stage for treatment referral. Prevention of prescription drug abuse by healthcare providers will require increased professional training of dental and other healthcare professionals in the recognition and prevention of misuse, abuse, and diversion. In 2007, NIDA established Centers of Excellence (NIDA-CoEs) in collaboration with a consortium of medical schools to fill gaps in the curriculum related to illicit and prescription drug abuse and to recognize early use in order to prevent an ensuing path to addiction and abuse (Denisco et al., 2011; NIDA, 2014a). The ADA has also called on dental educators to increase their content on this subject to better prepare practitioners to participate fully in prevention efforts. education programs to more completely address the national problem of prescription drug abuse. The federal government has issued a call to train healthcare providers to identify early signs of an opioid use disorder among their patients (ONDCP, 2018). Dental providers and dental educators are well positioned to collaborate in research activities and to incorporate research findings into practice to promote the safe and effective use of prescription drugs and, in turn, play a significant role in addressing the prescription drug abuse epidemic plaguing the nation. National Institute on Drug Abuse (NIDA) The National Institute on Drug Abuse (NIDA), an arm of the National Institutes of Health (NIH), supports research to prevent and treat drug abuse and addiction. The NIDA website provides extensive information on drugs of abuse and related topics as well as links to publications and external resources. The Institute provides extensive resources for the health professional, as well as for researchers, patients and families, parents and teachers, and students and young adults. Website: https://www.drugabuse.gov Screening, Brief Intervention, and Referral to Treatment (SBIRT) Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based tool for community-based screening for risky health behaviors, including substance use. This and other more detailed information and resources are available through the SAMHSA-HRSA [Health Resources and Services Administration] Integrated Health Solutions website. Website: https://www.integration.samhsa.gov/clinical-practice/sbirt Substance Abuse and Mental Health Services Administration (SAMHSA) The Substance Abuse and Mental Health Services Administration (SAMHSA) is a government organization that focuses on the link between behavioral health and overall health, specifically as it relates to substance abuse. The SAMHSA website provides resources for both individuals and professionals, including downloadable publications and educational resources. The Substance Abuse and Mental Health Services Administration directs individuals with concerns about treatment or who are seeking referral to treatment to various Web
pages or its 24-hour referral helpline. Website: https://www.samhsa.gov
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