Pre-procedural Counseling for Opioid Use, Abuse, and Disposal

While approximately half of dentists reported consistently counseling patients regarding the potential side effects of opioid medications, significantly lower percentages consistently discussed nonmedical use (27%), secure storage (18%), and disposal of unused medications (13%). ¹⁷ Patients are largely unaware of what may constitute misuse of medications, including sharing medications with friends or family members⁹⁶ and may also be unaware of the potential for diversion or misuse by others if they are stored or disposed of improperly.^97,98 Approximately three-quarters of unused opioid prescriptions are stored in an unmonitored, unsecured location within the home, which can be a risk for diversion and misuse.⁹⁹ A study of young, urban injection drug users interviewed in 2008 and 2009 found that 89% had used opioid pain medications nonmedically prior to using heroin and that their initiation to nonmedical use came from three main sources of opioids: family, friends, or personal prescriptions.¹⁰¹ Educating patients with regard to their role in preventing the opioid crisis allows for a reduction in accessibility of prescription medications to vulnerable individuals. The National Institutes on Drug Abuse suggests that patients take these steps to ensure the security and safety of their prescription medications:

• Following the directions as explained on the label or by the pharmacist

• Being aware of potential interactions with other drugs as well as alcohol

• Never stopping or changing a dosing regimen without first discussing it with the doctor

• Never using another person’s prescription, and never giving their prescription medications to others

• Storing prescription stimulants, sedatives, and opioids safely

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Additionally, patients should properly discard unused or expired medications by following U.S. Food and Drug Administration (FDA) guidelines or visiting U.S. Drug Enforcement Administration collection sites.¹⁰³

Standardization of patient education and the production of patient education materials discussing the risks of misuse of opioid prescriptions, once they have been deemed appropriate by the dental healthcare provider, may help alleviate some of the risks associated with failure to properly secure medications by patients. Members of the dental team can be employed to conduct the screening and/or provide post-prescription education to patients in a verbal and/or written format.