Discussing Addiction Responsibly in the Dental Field

By kieferpix / stock.adobe.com

I was absolutely horrified sitting in a Bureau of Workman’s Comp conference this week as I listened to the speaker say, “The biggest reason for addiction is the prescribing of medications that dentists do.” He was sharing his views with a Zoom audience of 3000 attendees. He gave no research or proof to back this theory up. It was just “his opinion.” Alluding to anecdotal examples is not enough. He was irresponsible! Do not worry, I shared my thoughts with them.

When I was a drug counselor, one of the biggest challenges was working with patients addicted to prescription medication. This challenging patient population was vastly different from patients with illegal drug addiction. Some began down their path to addiction from a car accident or a pain problem that led to pain management. The pain did not necessarily get better. Instead, it triggered addiction in some patients. They got on a roller coaster that destroyed their lives and was a continual chase for pain relief. There really is no way to know who will become addicted. Yes, having a family predisposition to addiction is a way to be aware of the potential, but not everyone with a chemically dependent parent becomes addicted.

I remember having a patient with a hairline fracture on his spine. He would go from ER to ER to get Oxycodone. It was a legit diagnosis on x-ray, and it was how he fueled his addiction. He struggled with accepting there was a problem. He was just in pain. I have no doubt that he suffered. Pain changes people. It makes you short tempered, depressed, overwhelmed, and feeling hopeless. For some, it creates desperation to do anything you can to get out of pain.

People get injured at work, need pain medication, and some become addicted. When they cannot get the pills from the doctor or legitimate sources, they start stealing from medicine cabinets in the homes of family and friends. From there, they may turn to alcohol to manage the pain. When access to getting pain medication becomes a problem, they cross over into illegal drugs. This is why so many people have no idea they are addicted. They feel that they were just trying to cope with the pain.

What was infuriating at this conference was for a speaker, who is not a researcher or a healthcare provider, to get up and make a blanket statement blaming dentists for the opioid problem in this country. This was a speaker who struggled with his own demons of addiction taking him from multimillion dollar companies he built to prison and back again. His struggle was real. His talent at reinventing himself repeatedly and hitting bottom over and over again was inspiring. That was until he made this comment. He went on to say how dentists prescribe pain killers with 30 in the bottle which starts down the road of addiction. Really? With my dental team if I need pain medication it is 3-4 pills that is prescribed for me. I have seen a lot of dental professionals in my lifetime and never has there been an overabundance of prescription pain medication prescribed to me. That is not to say that it does not happen, but this is my point. This speaker cannot generalize across the board without any evidence-based research proof that his theory has validity to it.

There have been changes in this industry because of the opioid problem. Being irresponsible and putting the burden of this epidemic on dentists is preposterous. This is not about finger pointing. It is about tackling a health crisis we are battling. To do so, all of us need to step up and be vigilant to make sure patients receive the care that they need. That means prescribing the appropriate quantity and monitoring our patients. Codeine, Oxycodone, and Tramadol are the three biggies. Follow guidelines and prescribe responsibly, but make sure you stand up at a conference if an entire profession gets scapegoated as the cause of addiction. 

Email me at diana2@discussdirectives.com and share with me your thoughts on the topic of dentistry and opioid usage. Share what you have seen and what way we can tackle addiction.