Do you prescribe opioids and if so what guidelines do you yourself follow in administering them?

[ngheibid]

I'm in dental school and need to complete an assignment by interviewing a dentist.

Anyone interesting in answering 5 questions about their personal practice?

It would be greatly appreciated!


1. How do you manage acute pain?

2. Do you prescribe opioids and if so what guidelines do you yourself follow in administering them? Dosing, numbers prescribed and recall interval are all possible follow up issues.

3. Do you screen for substance abuse? If so, how? Do you use any screening tools (written or verbally; CAGE-AID)?

4. What do you say and how do you say it in learning about any possible abuse? Verbal and nonverbal communication included.

5. If a patient has a perceived or overtly shared drug abuse problem then how do you manage this situation? Advise? Assisting? Referral?

 

[honestdoc]

1. I would diagnose the patient if it is tooth related or something else. If it is tooth related, I would treat it appropriately such as restoration, root canal, or extraction. If I can't determine the source of pain, I refer the patient to his/her medical doctor for evaluation of possible sinus pain or other conditions such as Trigeminal Neuralgia. Dr. Jeffrey Okeson from University of Kentucky has great information on non-dental pain in the oral area.

2. I do prescribe opioids. If it is an intial visit, I review the medical history and interview the patient. I will usually take care of the acute problem on the same day. I will prescribe opioids after treatment or if I can't complete the procedure. I will not prescribe if the patient refuses treatment. Dosing is usually 5.0 to 7.5 mg Hydrocodone, 5.0 mg Oxycodone, 30 mg Codeine.

3. I only screen suspected abusers. We have a state opioid database.

4. Ask patients about their history of pain medication/street drug use. It can be difficult to determine validity.

5. Discuss drug rehab and NSAIDs use.

 

[ngheibid]

You are truly my savior right now! Thank you SO much for taking the time to thoroughly answer that, I really appreciate it!