Paper Example on Prescribing Opioids in US: Dentists Lead the Way

Volkow, Nora D., et al. "Characteristics of opioid prescriptions in 2009." Jama 305.13 (2011): 1299-1301.

The United States of America is noted to consume large amounts of opioids, leading to both the use and sadly the misuse of the drugs. Dentists are the most prevalent known medical personnel who prescribe opioids in the United States, regardless of data suggesting that nonopioid pain relievers are equally effective (Nora et al., 1299). Like all prescriptions, opioids are excellent pain relievers when used responsibly and per the doctor's prescription. However, when misused even with the best of intentions such as helping a friend or relative with said opioids can be dangerous as one may become highly addicted to the said drugs, and this may lead to overdose incidents or deaths. The main objective of this study is to look into the controversies in dentistry. The study also has compared the merits and demerits of the use of opioids. I will aim to show that the use of opioids is harmful, and continuous use of the same leads to dangerous consequences to the user (s).

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Even with all the negativity surrounding the use of opioids, some argue that with a physician's supervision, opioids are the best in treating persistent and severe pain. Opioids can be used to relieve pain in cases of chronic headaches and backaches and other bodily pains. They have also been seen to treat coughing and diarrhea. However, the best argument for the use of opioids is in the use of them as an option for people with cancer. Those in support of these narcotics feel that to reduce extended and repeated hospital stays, or a disruption of the daily lives of those living with cancer, opioid treatment could play a vital role.

The National Institute on Drug Abuse states that opioids activate cellular structures on several organs found in the human being, such as the brainpower and the spinal cord. When these drugs attach to the said reactors, they tend to block the cells sending several signals such as pain to the brain cells while releasing large amounts of dopamine, a feel-good neurotransmitter, throughout the body. This feel-good neurotransmitter may reinforce the craving of the opioids, which could easily lead to addiction for the user. Some of the effects these opioids may have on the brain and the body include drowsiness, nausea, confusion, constipation, euphoria, and or, worse of all, slowed breathing. Slowed down breathing may lead to anoxia or hypoxia. These two conditions can easily lead to either a coma, permanent brain damage, or even death of the use.

Bote, Sunghee H. "U.S. Opioid Epidemic: Impact on Public Health and Review of Prescription Drug Monitoring Programs (PDMPs)." An online journal of public health informatics vol. 11,2 e18. 19 September. 2019, DOI:10.5210/ojphi.v11i2.10113

As per this article, the opioid epidemic in the United States has declared a national public health emergency on 26 October 2017. The Center for Disease Control and Prevention (CDC) estimates that 130 U.S. lose their lives as a result of opioid overdose daily, with 46 overdose deaths involving prescription opioids. The death toll from legal and illegal opioid use has increased 6-fold between 1999 and 2017. The use of opioids has brought about approximately 68% of all drug overdose deaths in 2017, while 35% of all opioid deaths involved prescription opioids such as methadone, oxycodone, and hydrocodone. There has been a rampant increase in deaths between 2000 and 2014 as a result of overdose in opioids.'

Further, he noted that heroin is an illegal semi-synthetic opioid drug that is highly addictive. It is estimated that approximately two out of 1,000 people in the U.S. used heroin in 2017, and the most notable increases in heroin use are in women. Other opioids such as Fentanyl, which is a synthetic opioid, are used as a pain reliever, but a misuse of the same can lead to an addiction.

The use of opioids by pregnant women could lead to an increased risk for both the mother and the baby. It could bring about other complications such as pre-term delivery, congenital disabilities, and or neonatal opioid withdrawal syndrome, and this occurs as the baby has already been addicted to opioids being taken by the mother. People with renal or hepatic insufficiency are also at a high risk of prescribed opioids because of their inability to quickly process or excrete the drugs in their systems, leading to an accumulation of opioids in their operations. Further, another group is people who have had substance use disorder in the past are also in a risk of becoming addicted to opioids. It is also not advisable to have people from the age of 65 and above on prolonged use of opioids. This is because their metabolism and renal systems have slowed down, making it very difficult to metabolize the drugs in their operations, this buildup of opioids in the body systems may bring about a drug affinity resulting to addiction and or other complications to their immune systems. Mentally imbalanced people may also experience adverse opioids effects because these narcotics may mix with their medications, causing a chemical imbalance. Medical practitioners should, therefore, exercise caution as they prescribe these opioids to their patients. To treat opioids, naloxone is the drug used to reverse the excessive use of an opioid. It counteracts the effect of the opioid, thus restoring the regular breathing of a person with bradypnea or shallow breathing as a result of excessive use of drugs.

The American Journal of Preventive Medicine - Overprescribing of Opioids to Adults by Dentists in the U.S., 2011-2015.

According to this article, pain experienced after surgery is often manageable. Thus dentists should prescribe drugs with lesser effects on the body systems of the user, such the over- the -counter medicines without steroids intended to reduce inflammation in comparison to the norm that is of issuing potent narcotics or rather strong pain killers.'

Non-Steroidal Anti- Inflammatory Drugs (NSAID) are useful and usually sufficient for controlling pain. Having a background on the cause of the pain should enable dentists to prescribe the appropriate NSAIDs as their effects on the user are not as critical as those of opioids. NSAIDs can reliably be used to treat an infection if prescribed together with an appropriate antibiotic, instead of having to prescribe an opioid such as hydrocodone or oxycodone (Reynolds & Evan 347).

In conclusion, dentists use opioids in the USA as a postoperative pain reliever, and studies, however, indicate that dentists, unfortunately, prescribe more than the permitted dosage, which could easily cause the user of the said opioids to become addicted to them.

Dentists and pharmacists should work in collaboration with opioid prescriptions. This will help contain the misuse. Further, the focus should mainly be on individuals who visit health facilities and dictate their treatment plans. The U.S. government has put in place some guidelines to control the usage of opioids by dentists. Some of these measures include surveillance and technology drives, such as the CDC-Funded Enhanced State Opioid Overdose Surveillance Program (ESOOS). This program aims at identifying the areas that require remedies in regard to the usage of opioids.

Another tool being used is the Prescription Drug Monitoring Programs (PDMP). The objective of this program is to equip prescribers of these drugs with the necessary support tools, to ensure that they have accurate information on a patient before actually prescribing opioids to them. This is crucial because, as earlier established, there are specific groups of individuals who should never be prescribed potent opioids for usage on a continuous

I feel that other than the support systems mentioned above, together with other guidelines by various institutions such as the CDC, which has established and put in place guidelines for Prescribing Opioids for Chronic Pain, there is still room for more to eradicate or minimize the use of opioids. For example, in the United Kingdom, strict rules are in place, which demands a keen observance of the use of pain-relieving opioids. This should be the case in the U.S. to help dentists decide on the appropriate treatment for their patients.

Prescription of opioids should be considered as the very last option, dentists, therefore, have a responsibility to curb this menace of prescribed opioids being used for other illicit purposes.

Works Cited

Bote, Sunghee H. "U.S. Opioid Epidemic: Impact on Public Health and Review of Prescription Drug Monitoring Programs (PDMPs)." An online journal of public health informatics vol. 11,2 e18. 19 September. 2019, DOI:10.5210/ojphi.v11i2.10113

NIDA. "Prescription Opioids." National Institute on Drug Abuse, 27 June. 2019, https://www.drugabuse.gov/publications/drugfacts/prescription-opioids. Accessed 7 April. 2020Reynolds, William R, and Evan S Schwarz. "Dentists' Current and Optimal Opioid Prescribing Practices: A Proactive Review." Missouri Medicine, vol. 116,5 (2019): 347-350.

Suda, Katie J., et al. "Overprescribing of Opioids to Adults by Dentists in the U.S., 2011- 2015." American Journal of Preventive Medicine (2020).

Volkow, Nora D., et al. "Characteristics of opioid prescriptions in 2009." Jama 305.13 (2011): 1299-1301.