American dentists prescribe opioids much more often than their British counterparts

A new study reveals that American dentists prescribe 70 times more opioids than English dentists.

In addition, the types of opioids prescribed by American dentists are more likely to be those with "high potential for abuse, such as oxycodone," researchers reported in JAMA. Network Open.

"Dentists are one of the best prescribers of opioids, just behind family doctors," said study lead author Katie Suda, badociate professor of pharmacy at the University of Illinois, Chicago, College of Pharmacy. "If you look at the medications prescribed by dentists, opioids are the second most common after antibiotics."

Studies have shown that even though opioid prescribing rates have generally decreased, prescription rates for dental products have increased, noted Suda and colleagues. And this, despite the fact that research shows that non-opioid badgesics are as effective as opioids for the control of dental pain, said Suda.

"In our study, we found that one in ten opioids (prescriptions) from American dentists was intended for high concentration opioids, whereas in England, dentists had prescribed none", said Suda. "The English model is very different.There are specific guidelines for the treatment of oral pain.They recommend as first-line treatment non-opioid badgesics: their version of acetaminophen and an NSAID."

To look more closely at opioid prescription regimens among American dentists, Suda and his colleagues turned to two databases. Data for US dentists comes from IQVIA LRx, which contains data on 85% of all outpatient prescriptions and includes those written for patients covered by commercial, Medicare and Medicaid insurers. Data for English dentists come from the NHS digital prescription cost badysis and cover 84% of the UK population.

In 2016, US dentists wrote more than 11.4 million prescriptions for opioids, while English dentists wrote 28,082 prescriptions for these drugs. The proportion of all dental prescriptions written for opioids was 37 times higher in the United States than in England.

In addition, American dentists have prescribed opioid prescriptions at a rate more than 70 times higher than their English counterparts: 35.4 opioid prescriptions per 1,000 Americans have been prescribed in the United States , while English dentists have prescribed 0.5 opioid prescription per 1,000 Britons.

While other health professionals have paid a lot of attention to the prescription of opioids, "few public health efforts have focused on dental providers", said Mr Suda. "We were surprised by the magnitude of the difference."

Dr. Joel Hudgins, recent author of a study on opioid prescriptions written by general practitioners for adolescents and young adults, said struck by the magnitude of the difference between English and American dentists. "The measure that matters, American dentists who prescribe opioids at a rate 70 times higher than that of English dentists, may be an indicator of the amount of opioids entering the population," said Hudgins, clinical instructor at Boston Children's Hospital and Harvard Medical. School.

Curiously, the results of the new study were consistent with the findings of the Hudgins study: emergency physicians had prescribed opioids to almost 60% of young patients with dental disorders.

Dr. Michael Lynch suspects that similar differences in opioid prescription would be observed if one compared other specialties.

"It is clear that too many opioids are prescribed and we want to make sure we reduce the rate responsibly, while ensuring that the pain is adequately treated," said Lynch, a toxicologist and emergency physician. Medical Director of the Pittsburgh Poison Center at the University of Pittsburgh Medical Center.

Lynch noted that people should take care to get rid of the remaining pills, so that they are not available to others.