State Opioid Prescribing Limits Did Little to Reduce Length of Dental Prescriptions

PainRelief.com Interview with:
Kao-Ping Chua, MD, PhD
Susan B. Meister Child Health Evaluation and Research Center
Department of Pediatrics, University of Michigan Medical School
Ann Arbor MI 48109.

Kao-Ping Chua
Dr. Kao-Ping Chua

PainRelief.com: What is the background for this study? What are the main findings?

Response: U.S. dentists account for approximately 11 million opioid prescriptions each year. Excessive opioid prescriptions from dentists can result in leftover opioids that can be diverted or misused. In part to prevent this, most states enacted policies between 2016 and 2018 that restricted the duration of opioid prescriptions for acute pain, such as dental pain.

The objective of this study was to evaluate whether these state opioid prescribing limits were associated with reductions in the duration of opioid prescriptions from dentists. Using national prescription dispensing data from 2014-2020 and a rigorous quasi-experimental study design, we found that this duration did not change after limit enactment. A likely explanation is that most limits allow up to a 7-day supply of opioids, but the typical duration of dental opioid prescriptions during the study period was about a 3-day supply. For this reason, state limits had little ability to reduce this duration in the first place.

Patients Report Substituting Cannabis for Pain Relief Medications

PainRelief.com Interview with:
Mark Christopher Bicket, MD, PhD
Assistant Professor,Department of Anesthesiology
Assistant Professor,Health Management and Policy
School of Public Health
University of MichiganAnn Arbor, MI 48109

PainRelief.com: What is the background for this study? What are the main findings?

  • Most states have laws that allow people with chronic pain to use cannabis as a treatment. But evidence about whether medical cannabis use lowers the use of other treatments for chronic pain is not clear. 
  • We conducted a rigorous survey of adults living in the 36 states and D.C. in the spring of 2022.
  • Among the 1,661 adults who had chronic pain, we asked about their use of cannabis, prescription opioids, and non-opioid treatments for chronic pain. 
  • Cannabis use for chronic pain was common, reported in roughly 3 in 10 people at any time and 1 in 4 in the past year.
  • In contrast, a minority said cannabis use decreased their use of non-pharmacologic treatments like physical therapy or meditation, and some reported their use increased.

Opioid Prescriptions Differ Between Surgeons and Advanced Practice Clinicians

PainRelief.com Interview with:
Caitlin Priest, MD
Integrated Plastic Surgery Residency
Department of Surgery
Michigan Medicine

Dr. Priest

PainRelief.com: What is the background for this study? What are the main findings?

Response: Opioid pain medications are commonly provided after surgery to help with acute postsurgical pain, however, these prescriptions often exceed what is used by most patients, resulting in excess opioids. Advanced practice clinicians (nurse practitioners and physicians assistants) are becoming an increasingly important part of surgical care teams. Despite their growing role in providing care for surgical patients, there is little data on the perioperative opioid prescribing practices of advanced practice clinicians.

Policymakers Can Mitigate Prescription Opioid Misuse Associated with Delayed Dispensing for Pain Relief after Procedures

PainRelief.com Interview with:
Kao
Ping ChuaMD, PhD
Department of Pediatrics
Susan B. Meister Child Health Evaluation and Research Center
University of Michigan Medical School
Department of Health Management and Policy
University of Michigan School of Public Health, Ann Arbor

PainRelief.com:  What is the background for this study? 

Response: Opioid prescriptions written by dentists and surgeons are almost always written for the immediate relief of acute pain after procedures. However, current federal and state laws allow these prescriptions to be dispensed well after the time that they are written. When this occurs, that could be a potential sign that the prescription was used in a time frame or for a reason other than intended by the prescriber, both of which are forms of prescription opioid misuse.