U.S. Dental Opioid Prescribing: Epidemiology and Policy Interventions

Project start date and end date: 2020 - 2023

Background:

Dental opioid prescriptions are an important driver of the U.S. opioid epidemic. In 2016, U.S. dentists prescribed opioids more than 50 times more frequently as United Kingdom dentists, in part because the former routinely prescribe opioids after minor procedures such as wisdom tooth extraction. Although the harms associated with dental opioid prescribing affect all age groups, they disproportionately affect adolescents and young adults, for whom dentists are among the most common sources of opioids. In a study of adolescents and young adults who filled an opioid prescription within three days of wisdom tooth extraction, 1.3% continued to fill opioid prescriptions up to a year later (“persistent opioid use”).

Objectives:

In this proposal, we will use state-of-the-art national data to characterize the landscape of U.S. dental opioid prescribing; evaluate the effects of policies on dental opioid prescribing; assess the prevalence and harms associated with dental opioid prescriptions that are dispensed well after dental pain resolves; and conduct a detailed analysis of the harms of dental opioid prescribing.

Research Topics & Methods:

The objectives of this grant are to describe the prevalence, prescribers, and safety of dental opioid prescribing, and to evaluate the effects of opioid prescribing limits and prescription drug monitoring program use mandates on this prescribing. Analyses involve the use of the IBM MarketScan Commercial Database, T-MSIS Analytic Files, the IQVIA Longitudinal Prescription Database, the IQVIA Formulary Impact Analyzer, and data from the Prescription Drug Abuse Policy System.

Implications:

This study will provide critical information that will motivate interventions to reduce unnecessary dental opioid prescribing while informing how these interventions should be designed.

Funder:

Benter Foundation

Collaborators:

Chad Brummett (MPI), Jennifer Waljee (Co-I), Romesh Nailliah (Co-I)