Opioid Analgesics and Rates of Fatal Drug Poisoning in the United States

The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics. Survey weights were incorporated to handle the sampling design. The prescription of opioid analgesics following dental care increased over time. After adjusting for sociodemographic factors, source of payment, and type of dental procedure, the odds ratio (OR) of prescribing opioid analgesics following a dental visit per each decade difference was 1.28 (95% confidence interval [CI], 1.19–1.38). Surgical, root canal, and implant procedures had the highest rates of opioid prescriptions and the greatest increases in rates over the study period. After adjusting for personal characteristics and type of dental procedure, the OR of receiving a prescription for opioids comparing blacks, Asians, and Hispanics to whites was 1.29 (95% CI, 1.17–1.41), 0.57 (95% CI, 0.47–0.70), and 0.84 (95% CI, 0.75–0.95), respectively. Opioid analgesic prescriptions following dental visits increased over time after adjusting for personal characteristics and type of dental procedure. The odds of receiving a prescription for opioids were higher for certain racial/ethnic minority groups. Knowledge Transfer Statement: This study highlights dental professionals prescribing practices of opioid analgesics by following dental treatments in the United States. With this knowledge, appropriate guidelines, protocols, and policies can be developed and implemented to address any inappropriate prescribing practices of opioid analgesics. In addition, this information could lead to an improvement in the prescribing practices of dental professionals and to evidence-based therapeutic decision making.

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Trends in Abuse of OxyContin® and Other Opioid Analgesics in the United States: 2002-2004

Journal of Pain ◽

10.1016/j.jpain.2005.05.004 ◽

2005 ◽

Vol 6 (10) ◽

pp. 662-672 ◽

Cited By ~ 288

Author(s):

Theodore J. Cicero ◽

James A. Inciardi ◽

Alvaro Muñoz

Keyword(s):

United States ◽

Opioid Analgesics ◽

The United States

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Increasing deaths from opioid analgesics in the United States

Pharmacoepidemiology and Drug Safety ◽

10.1002/pds.1276 ◽

2006 ◽

Vol 15 (9) ◽

pp. 618-627 ◽

Cited By ~ 441

Author(s):

Leonard J. Paulozzi ◽

Daniel S. Budnitz ◽

Yongli Xi

Keyword(s):

United States ◽

Opioid Analgesics ◽

The United States

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ß2-Arrestin germline knockout does not attenuate opioid respiratory depression

10.1101/2020.08.28.272575 ◽

2020 ◽

Author(s):

Iris Bachmutsky ◽

Adelae Durand ◽

Kevin Yackle

Keyword(s):

United States ◽

Respiratory Depression ◽

Side Effect ◽

Opioid Analgesics ◽

The United States ◽

Common Side Effect ◽

Signaling Mechanism ◽

Downstream Signaling ◽

Respiratory Behavior ◽

Downstream Signaling Pathway

AbstractOpioids are perhaps the most effective analgesics in medicine. However, from 1999 to 2018, they also killed more than 400,000 people in the United States by suppressing breathing, a common side-effect known as opioid induced respiratory depression. This doubled-edged sword has inspired the dream of developing novel therapeutics that provide opioid-like analgesia without respiratory depression. One such approach has been to develop so-called ‘biased agonists’ that activate some, but not all pathways downstream of the µ-opioid receptor (MOR), the target of morphine and other opioid analgesics. This hypothesis stems from a study suggesting that MOR-mediated activation of ß2-Arrestin is the downstream signaling pathway responsible for respiratory depression, whereas inhibition of adenylyl cyclase produces analgesia. To further verify this model, which represents the motivation for the biased agonist approach, we examined respiratory behavior in mice lacking the gene for ß2-Arrestin. Contrary to previous findings, we find no correlation between ß2-Arrestin function and opioid-induced respiratory depression, suggesting that any effect of biased agonists must be mediated through an as-yet to be identified signaling mechanism.

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The Misuse and Abuse of Prescription Medications: Medical Regulation, Prevention and Care Initiatives in New Jersey

Journal of Medical Regulation ◽

10.30770/2572-1852-100.3.7 ◽

2014 ◽

Vol 100 (3) ◽

pp. 7-18

Author(s):

Sindy M. Paul ◽

Virginia Allread

Keyword(s):

United States ◽

New Jersey ◽

Opioid Analgesics ◽

The United States ◽

Heroin Addiction ◽

Prescription Drug Abuse ◽

Drug Problem ◽

Prescribing Practices ◽

Medical Regulation ◽

State Medical Boards

ABSTRACT Prescription drug abuse is considered the fastest growing drug problem in the United States. The major increase is in unintentional drug overdose from opioid analgesics, which has caused more overdose-related deaths since 2003 than cocaine and heroin combined. The misuse of prescription pills is becoming particularly prevalent among suburban and rural youth in the United States, sometimes leading to heroin addiction and putting this population at a higher risk of blood-borne pathogens where heroin is injected. New Jersey has spearheaded initiatives to address misuse of opioid analgesics. These initiatives, which are part of an overall strategy and include medical regulatory response, are consistent with the newly (2013) updated Federation of State Medical Boards (FSMB) guidelines to better educate physicians and aid in the proper diagnosis and treatment of pain. They address physician prescribing practices, consumer need for safe disposal and treatment, and educational campaigns that target providers and the general public.

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