Journal of dentistry · 2025
The prevalence of persistent opioid use following dispensed dental opioid prescriptions in Australia.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Teoh Leanne, Taylor Marietta, Lim Mathew, McCullough Michael, Page Amy, Sanfilippo Frank M, Etherton-Beer Christopher, Preen David, Kelty Erin
Аннотация
BACKGROUND: Dental prescribing of opioids has been associated with the development of persistent opioid use (POU). The aim of this study was to examine the incidence of POU arising from an initial dental opioid prescription to opioid naïve individuals in Australia between 2015-2022.
METHOD: This was a longitudinal, retrospective study using a 10 % sample of patients dispensed medicines through the Pharmaceutical Benefits Scheme. The study comprised of opioid naïve individuals, who were dispensed an opioid prescribed by a dentist between 2015-2022 in Australia. The primary outcome was the proportion of patients who developed POU. Three secondary outcomes were assessed: 1) the rate of dispensed opioids in the subsequent 12-month period, 2) the type and potency of dispensed opioids, and 3) factors associated with POU.
RESULTS: From 2015-2022, 97,233 opioid naïve patients were dispensed an opioid prescribed by a dentist. Of these, 1692 individuals (1.7 %) developed POU. Patients with POU received a subsequent opioid prescription from a non-dentist more frequently (72.1 %) than those with non-persistent use (48.9 %). Whilst the potency of the initial opioid prescription, measured in morphine milligram equivalence, was similar between POU and non-POU patients, the potency of subsequent opioid prescriptions supplied to individuals was 44.1 % greater in those with POU (161.4 mg, SD:338.4) than those without POU (112.0 mg, SD: 283.7).
CONCLUSIONS: A small proportion of opioid naïve patients who were dispensed an opioid prescribed by a dentist developed POU. These findings underpin the importance of reviewing patients with dental pain, and including dentists in real time prescription monitoring programs.
CLINICAL SIGNIFICANCE: There is a small but clinically significant proportion of opioid-naïve patients who may develop persistent opioid use following an opioid prescription from the dentist. This highlights the importance of understanding the role of opioids for dental pain, initiating opioids only when necessary and reviewing patients with pain.
METHOD: This was a longitudinal, retrospective study using a 10 % sample of patients dispensed medicines through the Pharmaceutical Benefits Scheme. The study comprised of opioid naïve individuals, who were dispensed an opioid prescribed by a dentist between 2015-2022 in Australia. The primary outcome was the proportion of patients who developed POU. Three secondary outcomes were assessed: 1) the rate of dispensed opioids in the subsequent 12-month period, 2) the type and potency of dispensed opioids, and 3) factors associated with POU.
RESULTS: From 2015-2022, 97,233 opioid naïve patients were dispensed an opioid prescribed by a dentist. Of these, 1692 individuals (1.7 %) developed POU. Patients with POU received a subsequent opioid prescription from a non-dentist more frequently (72.1 %) than those with non-persistent use (48.9 %). Whilst the potency of the initial opioid prescription, measured in morphine milligram equivalence, was similar between POU and non-POU patients, the potency of subsequent opioid prescriptions supplied to individuals was 44.1 % greater in those with POU (161.4 mg, SD:338.4) than those without POU (112.0 mg, SD: 283.7).
CONCLUSIONS: A small proportion of opioid naïve patients who were dispensed an opioid prescribed by a dentist developed POU. These findings underpin the importance of reviewing patients with dental pain, and including dentists in real time prescription monitoring programs.
CLINICAL SIGNIFICANCE: There is a small but clinically significant proportion of opioid-naïve patients who may develop persistent opioid use following an opioid prescription from the dentist. This highlights the importance of understanding the role of opioids for dental pain, initiating opioids only when necessary and reviewing patients with pain.