An interesting article titled Association between the COVID-19 outbreak and opioid prescribing by U.S. dentists written by Jason Zhang and et. al. appears in PLoS ONE, published on November 2, 2023, vol. 18, no. 11, pp. e0293621. The authors sought to evaluate the association between the COVID-19 outbreak and the rate of opioid prescribing by U.S. dentists
The opioid crisis in the United States has cast a long shadow, reaching even into the realm of dental care and widom teeth removal. While national efforts have led to a gradual decline in opioid prescribing overall as discussed in the post Oral Surgeon Opioid Prescribing Habits in the US during 2016 to 2019, the study reveals a worrying trend: the COVID-19 pandemic may paused the efforts on progress in the dental field.
For many years, the number of opioid prescriptions give out by dentists has been shrinking. Between 2016 and 2022, a significant drop of 44.7% was observed. This downward trend offered hope in the fight against opioid misuse. However, unfortunately the outbreak of COVID-19 impacted the trend.
The study found that the rate of decline in dental opioid prescribing significantly slowed down after the pandemic began. Prior to March 2020, the monthly decrease was a steady -3.9%. But starting in June 2020, the decline almost ground to a halt, dropping to -2.1% per month. The researchers used data from IQVIA, a company that tracks prescriptions dispensed at 92% of U.S. pharmacies.
This means there was an estimated 6.1 million more dental opioid prescriptions dispensed between June 2020 and December 2022 than what would have been expected without COVID, if the data trends continued with what was being tracked between January 2016 and February 2020. This unexpected slowdown raises serious questions about what happened during the pandemic to disrupt the progress previously made.
While the study doesn’t pinpoint the exact reasons for this development, it suggests several potential explanations. Reduced access to dental care during lockdowns may have led to delayed procedures and increased pain, prompting dentists to prescribe more opioids. Changes in patient behavior due to pandemic-related stress and anxiety could also have played a role.
This slowdown serves as a reminder that the fight against opioid misuse is not over. Dental opioid stewardship initiatives, which promote safe and appropriate prescribing practices, remain crucial.
The authors feel that more research is needed to understand the specific factors behind the slowdown of reducing opioid prescriptions in dentistry. This knowledge may help guide targeted interventions and public awareness campaigns. Ensuring safe and effective pain management strategies for dental patients while minimizing the use of opioid must remain a top priority in the fight against the opioid crisis.
The study had limitations including that the dental opioid dispensing rate may be an imperfect measure of prevalence if the mean size or duration of prescriptions changed.