CDA Essentials 2018 • Volume 5 • Issue 6

17 Issue 6 | 2018 | N ews and E vents The data from these studies show that, although there is a correlation between prescription opioids and the risk of problematic drug use, prescriptions by dentists account for a relatively small amount of all opioids dispensed at the pharmacy. – Dr. Aaron Burry ➜ Visit Oasis Discussions to hear the RCDSO discuss its report: wp.me/p2Lv6A-5Pj Dr. Jimoh discusses opioid prescribing by Nova Scotia dentists: wp.me/p2Lv6A-64c According to Dr. Kudirat Jimoh, who was a resident in the department of dental clinical sciences at Dalhousie University and lead author of the article, the study suggests there is still room for improvement. “Though it may seem that dentists are prescribing a small percentage of the opioid analgesics dispensed, compared to other prescribers, there are still a lot of opioid analgesics being prescribed, in absolute numbers,” says Dr. Jimoh. “Because our study dealt with aggregate data, we couldn’t tell what procedures opioid analgesics were being prescribed for, or what kind of patients were getting the prescriptions. So there is still a need for dentists to assess and review their prescription patterns, in terms of when to prescribe opioid analgesics, what dose to prescribe, and for how long.” Dr. Michael Gardner, RCDSO director of quality assurance, says the discrepancy in prescribing rates for dentists and physicians can be explained by the types of pain they typically treat. “The data showed that dentists generally prescribe for acute pain and they’re doing it once, whereas physicians often will be prescribing multiple times because they’re dealing with chronic pain,” he says. The RCDSO report concludes that their analysis “strongly suggests that dental patients in Ontario are getting the right drug, in the right amount and only once.” Nova Scotia A 2018 study looked at oral opioid analgesics prescribed by dentists in Nova Scotia between January 2011 and December 2015, using the provincial Prescription Monitoring Program database. The key findings of the study 2 include: • Opioid prescribing is common among dentists in Nova Scotia, with more than 70% of licensed dentists writing at least one prescription for opioid analgesics dispensed in pharmacies. • Similar to the data from Ontario, dentists made up only 17% of all opioid analgesic prescribers and accounted for less than 4% of all prescriptions dispensed. • The most commonly dispensed opioid analgesics over five years were codeine and codeine combinations (66%), followed by hydromorphone (20%) and oxycodone (12%). • Dentist prescribed less than 0.5% of the total amount of opioid analgesics dispensed at pharmacies (measured as total morphine milligram equivalent, MMEq) over 5 years. Dr. Aaron Burry, CDA associate director of professional affairs, believes the results of these studies show that dentists are doing their part to reduce opioid prescriptions. “The data from these studies show that, although there is a correlation between prescription opioids and the risk of problematic drug use, prescriptions by dentists account for a relatively small amount of all opioids dispensed at the pharmacy.” More likely, says Dr. Burry, is that overdoses and deaths in Canada are associated mainly with illicitly produced fentanyl, which was responsible for 72% of overdose deaths in 2017, and other illegal forms of opioids. a References 1.OpioidprescribingbyOntariodentists,2014-2016. RoyalCollegeofDentalSurgeonsofOntario. 2018. 2.JimohKO,MatthewsDC,BrillantM,Sketris I.Patternofopioidanalgesicprescription foradultsby dentists inNovaScotia,Canada. JDRClinTransRes .2018;3(2):203-11.