Dentist opioid prescribing 37-fold higher in U.S. vs England

  • JAMA Netw Open

  • International Clinical Digest
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Takeaway

  • Dentists in the U.S. prescribed opioids 37 times more often than dentists in England in 2016, despite similar rates of dental visits and oral health quality between the countries.

Why this matters

  • Efforts to reduce opioid misuse should include interventions aimed at U.S. dentists, who are the second-most frequent prescribers of opioids and who write one-third of the opioid prescriptions given to adolescents.

Study design

  • A cross-sectional study of outpatient dental opioid prescriptions in the United States and England in 2016.
  • Funding: NIH and others.

Key results

  • In 2016, 11.4 million dental opioid prescriptions were prescribed in the U.S. compared with 28,082 in England.
  • Dental opioid prescribing rate was 37 times higher in the U.S. (22.3% vs 0.6%; P<.001>
  • Opioid prescription rate was 58.2/clinician in U.S. and 1.2/clinician in England.
  • English dentists prescribed only dihydrocodeine.
  • Most commonly prescribed opioid analgesics by U.S. dentists were hydrocodone-based opioids (62.3%), codeine (23.2%), oxycodone (9.1%), and tramadol (4.8%).

Limitations

  • Observational design.

Coauthored with Antara Ghosh, PhD