Written By Kevin Kerfoot / Reviewed By Ray Spotts
A significant proportion of older patients receiving opioids at dental visits also use psychotropic medications, which can be a potentially harmful combination, say researchers at the University of Illinois Chicago and the University of Pittsburgh.
“Some of the most concerning negative outcomes of these combinations include overdosing on opioids or falling, which can necessitate a visit to the hospital, which in itself carries greater risk for older adults,” says Gregory Calip, associate professor of pharmacy systems, outcomes and policy at the UIC College of Pharmacy and corresponding author on the paper published in the journal Pharmacotherapy.
Dentists And increased opioid messaging
Rates of taking multiple medications – also known as polypharmacy - are high among older adults who are more likely to be managing more than one health issue at any given time. Psychotropic medications that act on the central nervous system, such as antianxiety or antidepressant medications, are especially dangerous if taken with opioids because they can interact with each other and have negative effects.
“Dentists are among the top prescribers of opioids,” says Katie Suda, professor of medicine at the University of Pittsburgh School of Medicine and principal investigator of the study. “It seems that the increased messaging regarding limiting opioid prescriptions has been aimed primarily at medical physicians and not tailored to other specialist providers, including dentists. This can have dire consequences. As we saw in our study, opioid interactions with other medications was likely responsible for the significant rise in emergency room visits and hospitalizations.”
“Although the percentage of opioids prescribed by dentists has decreased in the last 20 years, dentists must continue interprofessional collaboration with primary care physicians, pharmacists, and other health care providers to address devastating and preventable drug interactions affecting vulnerable patients who look to them for safe and compassionate care,” added Dr. Susan Rowan, executive associate dean and associate dean for clinical affairs at the UIC College of Dentistry.
The researchers looked at medical, dental and pharmacy claims data from 40,800 older adult dental patients who visited a dentist between 2011 and 2015 and were prescribed opioids. The average age of the patients included in the study was 69 years old and 45 percent were female. Of these patients, 10 percent were taking medications that are associated with increased risks for harm with opioid prescriptions. There were 947 hospitalizations or emergency room visits among these patients.
The researchers found that among patients prescribed opioids by their dentist, one in 10 was already taking a prescription medication that should not be prescribed with opioids. Patients inappropriately prescribed an opioid medication combination by their dentist were 23 percent more likely to be hospitalized or visit an emergency department in the 30 days after the dental visit where they were prescribed an opioid, compared with dental patients who were not prescribed an opioid medication.
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With over 30 years of writing and editing experience for newspapers, magazines and corporate communications, Kevin Kerfoot writes about natural health, nutrition, skincare and oral hygiene for Trusted Health Products’ natural health blog and newsletters.
Founder Ray Spotts has a passion for all things natural and has made a life study of nature as it relates to health and well-being. Ray became a forerunner bringing products to market that are extraordinarily effective and free from potentially harmful chemicals and additives. For this reason Ray formed Trusted Health Products, a company you can trust for clean, effective, and healthy products. Ray is an organic gardener, likes fishing, hiking, and teaching and mentoring people to start new businesses. You can get his book for free, “How To Succeed In Business Based On God’s Word,” at www.rayspotts.com.