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I think I’m done prescribing opioids

April 24, 2017
The opioid epidemic has caught Dr. Chris Salierno's attention, and he can say that he hasn't prescribed them in years. But media reports recognize that dental offices have had a role in the epidemic, news that should encourage dentists to think about their scripts.
Chris Salierno, DDS, Chief Editor, Dental Economics

The opioid epidemic has caught Dr. Chris Salierno's attention, and he can say that he hasn't prescribed them in years. But media reports recognize that dental offices have had a role in the epidemic, news that should encourage dentists to think about their scripts.

This article first appeared in the Principles of Practice Management e-newsletter. Click here to subscribe.

I honestly couldn’t tell you the last time I wrote an Rx for Vicodin. I don’t perform major dental surgery, and whenever I do, I find that 800 mg of ibuprofen works very well to keep patients comfortable. I would feel uncomfortable prescribing opioids for any of the other procedures I perform, even endodontics. I prescribe antibiotics and . . . well . . . that’s pretty much it. Once in a blue moon I’ll write a script for a muscle relaxer or anxiolytic for my TMD or fearful patients, respectively. But opioids? Not in years.

This subject has been on my mind since the U.S. Department of Health and Human Services has declared an opioid epidemic. Several major news outlets have done some fair reporting on dentistry’s role in the crisis, and I salute them for it. I graduated dental school in 2005 and immediately saw the demand from patients for “something stronger” than OTC pain medication. There were certainly times I felt the request for opioids was not appropriate due to the procedure being relatively minor or the patient behaving suspiciously. I don’t think I’m alone in that experience.

So, I’m glad that the government and the media are identifying the problem. The American Dental Association has done an admirable job assessing the problem and getting in front of it. This all helps to support us when we do have to have difficult conversations about pain management with our patients.

Now don’t get me wrong; I support the right for dentists to prescribe opioids. There are certainly those of us who do perform invasive procedures or otherwise have need of powerful pain management. But the time has come for the rest of us to carefully consider what role we will play in the opioid epidemic.

Cheers,