Prescription Opioid Pain Medication Use among Patients Attending a US Dental College Clinic: Prevalence and Implications

Research Article

Austin J Dent. 2023; 10(1): 1172.

Prescription Opioid Pain Medication Use among Patients Attending a US Dental College Clinic: Prevalence and Implications

Chana M¹; Harris R¹; Lewis KL²; Abebe W³*

¹Department of General Dentistry, Dental College of Georgia, Augusta University, Augusta, Georgia, GA 30912-1128, USA.

²Smile Blue Ridge, 47 Dunbarton Farm Rd, Blue Ridge, GA 30513, USA.

³Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, Georgia, GA 30912-1128, USA.

*Corresponding author: Abebe W Department of Oral Biology and Diagnostic Sciences, CL-2130, Dental College of Georgia, Augusta University, Augusta, GA 30912-1128, USA. Tel: 706-721-3181 FAX: 706-721-6252 Email: wabebe@augusta.edu

Received: May 01, 2023 Accepted: May 23, 2023 Published: May 30, 2023

Abstract

Purpose: Due to the increased opioids abuse in US during the past several decades, efforts have been made to counter this trend through regulation of use of prescription opioid pain medications. This study assesses the use of these medications by adult dental patients attending a US dental college clinic during February 2017 to October 2021.

Methods: A self-administered anonymous questionnaire was used to gather data from patients on demographics and patterns of utilization of medications.

Results: Among the patients included in the study, the majority were 51 to 70 years of ages, females, Caucasians, and with minimum high school education. Nine prescription opioid medications were used, and of these, hydrocodone and oxycodone were more common. Most patients used single medications, of which the majority were utilized for a few days up to 4 weeks. Nearly all medications were prescribed by 10 different health profession specialists, and the majority comprised emergency medicine physicians, primary health care practitioners and dentists. Most patients used their medications as intended, without sharing with others, and also expressed their satisfactions with the medications they used.

Conclusions: The study suggests that the recently reported opioid epidemic in US is less related to use of prescription medication, but to other external factors, including the non-medical use of potent synthetic compounds, such as fentanyl, as widely reported in the literature. Such a recognition, while warranting further studies on the topic, provides additional justifications for enhanced focus on this aspect of opioid abuse.

Keywords: Opioid pain medications; Dental patients; Opioid prescriptions; Opioid abuse

Abbreviations

WHO: World Health Organization; CDC: Center for Disease Control and Prevention; AMA: American Medical Association; ADA: American Dental Association.

Introduction

Opioid analgesics are used primarily for the management of moderate to severe pain, either alone or in combination with nonopioid analgesics, such as ibuprofen or acetaminophen. However, the use of these analgesics is often associated with a number of adverse effects, particularly if inappropriately used. These adverse effects include respiratory depression, tolerance, dependence, and addiction, among others, which are usually linked to the misuse and abuse of the drugs [1-4]. Of particular concern in this regard is addiction due to the intensity of its negative consequences and expansive prevalence.

The WHO has recently reported that cases of serious opioid adverse consequences due to over dosage have increased globally over the past several decades, in part due to increased use of these drugs in the management of chronic pain and the growing use of highly potent synthetic opioids that appear in the illicit market [5]. In the US, fatality due to opioid over dosage has been observed to rise by about 120% between 2010 and 2018, and two-thirds of this involved fentanyl and its synthetic analogues [5,6]. Similar observations have been made in other studies conducted under different settings [7-9]. Because of these alarming situations, concerned organizations, professionals and other stakeholders have taken greater initiatives to control the rising opioid epidemic by whatever means possible [10-15]. These initiatives include the way information about opioid medications is appropriately disseminated, the implementation of proper diagnosis of conditions to be treated, and the treatment and monitoring of patients who are prescribed opioid medications. However, it is not yet clear whether or not the application of these efforts has any impact on the current situation of the opioid epidemic in the USA. Largely driven with this curiosity and to provide a possible answer, the aim of the present study was to conduct a questionnaire-based assessment of the utilization of prescription opioid medications by adult dental patients attending a US dental college clinic during the period of February 2017 to October 2021.

Materials and Methods

A self-reporting anonymous questionnaire of two-pages was prepared to obtain data from adult dental patients attending the emergency clinic at the Dental College of Georgia at Augusta University regarding their demographic characteristics, use of prescription opioid analgesic medications and related information. The questionnaire and the method of its administration were approved by the Institutional Review Board of Augusta University. Demographic characteristics collected from a survey participant included data on age, gender, race/ethnicity and educational level. Regarding the use of medications, survey participants were asked to pick the prescription of opioids they used during the past 12 months from a list provided. Follow-up questions on medications were included to get additional insightful information. While the major portions of the questions in the questionnaire were closed-ended, other portions were left open-ended. The questionnaire was pre-evaluated to establish its utility by conducting a pilot study involving a small number of patients. From the feedback obtained, certain modifications were made on questionnaire to improve its utility.

Adult patients who came to the emergency clinic at the Dental College of Georgia at Augusta University during February 2017 to October 2021 were invited to voluntarily complete the questionnaire, as approved by the Institutional Review Board. Copies of the questionnaire were given to individual patients with appropriate explanations and instructions. Following receipt of responses from patients, the data from properly completed questionnaires were transferred to a database. The information thus collected was then compiled and analyzed systematically to examine the patterns and trends of utilization of prescription opioid medications, together with other relevant information included in the questionnaire.

Results

From 227 copies of the questionnaire returned by the study subjects with responses, 213 were found good enough for further consideration. Analysis of the data demonstrated that of the 213 patients, 43% reported the use of one or more single item prescription opioid pain medications. Data regarding the demographic characteristics of medication users, the types and durations of the medications used, prescribers seen by patients, other sources of medications, possible non-medical uses of the medications, whether or not the medications are shared with others, and how effective the medications were for patients are presented in Tables 1-9.

Demographic characteristics of opioid medication users

As displayed in Table 1, of 92 prescription opioid users, 27 (29%) were in the age group of 31-50 years, while 39 (42%) in the range of 51 and 70 years, comprising a total of 71% of the survey participants. This was followed by younger users that consisted of 19 (21%) individuals between the ages of 18 and 30 years. Seven (8%) patients were over the age of 71 years. Out of the 92 respondents, females were 53 (58%) and males 37 (42%). The majority (57%) of pain medication users were Caucasians followed by African Americans (36%), the remaining being only 8%. Whereas most medication users (72%) reported as having high school and some level of college education, the rest (28%) were college graduates (Table 1).