PainRelief.com: What are the main findings?
Response: Using a national database representing approximately two-third of prescriptions in the U.S., we determined how often opioid prescriptions from dentists and surgeons are dispensed more than 30 days after they are written. In 2019, our database contained 195,000 prescriptions with this “delayed dispensing.” Although this constituted a relatively small share of all opioid prescriptions from dentists and surgeons – about 1% – this is still a large number in an absolute sense, especially given that our database did not include all U.S. prescriptions.
We also researched the maximum period allowed between writing and dispensing of controlled substance prescriptions in each state. We found that 18 states allow prescriptions for Schedule II drugs –- those with the highest risk of diversion –- to be dispensed up to six months after writing. Another eight states allowed dispensing of Schedule II up to 1 year after writing. For Schedule III Drugs, 43 states allowed dispensing up to six months after writing.
Finally, we showed that delayed dispensing of opioid prescriptions from dentists and surgeons dropped immediately following implementation of a law in Minnesota that precluded dispensing of opioid prescriptions more than 30 days after writing.
PainRelief.com: What should readers take away from your report?
Response: Policymakers can mitigate any prescription opioid misuse associated with delayed dispensing by shortening the maximum period allowed between writing and dispensing of opioid prescriptions. To avoid unintentional access barriers for patients on long-term opioid therapy, one approach is to shorten this period only for opioid prescriptions written by clinicians who almost exclusively treat acute pain, like dentists and surgeons.
Surgeons and dentists could consider writing instructions to pharmacists that preclude opioid prescription dispensing after a certain period of time, such as 30 days. Hospitals could alter their electronic health record systems so that the default signature for perioperative opioid prescriptions contains these instructions.
PainRelief.com: What recommendations do you have for future research as a result of this work?
Response: Future studies should seek to understand the reasons that delayed dispensing occurs and whether this dispensing is associated with opioid-related harms.
Disclosures: I received an honorarium from the Benter Foundation for work on a campaign to improve opioid prescribing practices by dentists.
Chua K, Waljee JF, Smith MA, Bahl S, Nalliah RP, Brummett CM. Estimation of the Prevalence of Delayed Dispensing Among Opioid Prescriptions From US Surgeons and Dentists. JAMA Netw Open. 2022;5(5):e2214311. doi:10.1001/jamanetworkopen.2022.14311
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