Prescription opiate use and the Dental Setting
We analyze prescription-level data from the IMS Health LifeLink™ LRx Longitudinal database in eleven states to examine the role of dentists in one particular pattern of behavior associated with problematic opioid use: "Provider shopping." In particular, we identified every patient who received opioid prescriptions from (1) at least five different providers (dentists, doctors, or others), and (2) filled these prescriptions in at least five different pharmacies within six months during 2012.
Following this method, we identified 165,430 unique “provider-shoppers”, who filled 3,981,018 unique opioid prescriptions, an estimated prevalence similar to those found by other researchers. 3.8% of these opioids were prescribed by dentists. Almost one-third (31.9%) of identified provider-shopping patients received at least one opioid prescription from a dentist.
Most “provider-shoppers” filled only one or two dental opioid prescriptions, or none at all. Although most “provider-shoppers” received opioid prescriptions from only one dentist, 1,299 received prescriptions from at least five dentists. We identified 42,420 unique dentists who provided at least one opioid prescription to a “provider-shopping” patient. Most dentists prescribed to only one such patient. Yet, 3,093 dentists provided prescription opioids to five or more. 591 dentists prescribed opioids to ten or more “provider-shopping” patients.
Our analysis underscores the importance of dentists in problematic forms of prescription opiate use. Policy implications are discussed.
Learning Areas:Biostatistics, economics
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy
Identify the prevalence of specific indicators of prescription opiate misuse in the dental setting.
Keyword(s): Prescription Drug Abuse and Misuse, Oral Health
Qualified on the content I am responsible for because: I have performed the statistical analyses described in the abstract and am lead author
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.