Dentists, opioids, and international disparities

Opioid use in the United States of America is disproportionately high compared to other part of the world. Dentists in the US are frequent prescribers of opioids, and researchers have recently compared opioid prescribing by dentists in the United States and England. In 2016, the proportion of prescriptions written by US dentists that were for opioids was 37 times greater than the proportion written by English dentists. Over 22% of US dental prescriptions were for opioids compared with 0.6% of English dental prescriptions (difference, 21.7%; 95% CI, 13.8%-32.1%; P < .001). Dentists in the USA issued a higher number of opioid prescriptions per 1000 population (35.4 per 1000 US population [95% CI, 25.2-48.7 per 1000 population] vs 0.5 per 1000 England population [95% CI, 0.03-3.7 per 1000 population]) and a higher number of opioid prescriptions per dentist (58.2 prescriptions per dentist [95% CI, 44.9-75.0 prescriptions per dentist] vs 1.2 prescriptions per dentist [95% CI, 0.2-5.6 prescriptions per dentist]). Dihydrocodeine was the only opioid prescribed by English dentists, but US dentists prescribed a range of opioids containing hydrocodone (62.3%), codeine (23.2%), oxycodone (9.1%), and tramadol (4.8%).Given the problems inherent to opioid usage patterns in the USA, it appears self-evident that given the pattern of dental procedures performed in the two nations are similar, dentists in the USA may be one source contributing to high opioid usage rates in that country. Read the full paper here