Entries tagged with “opioids”.


dentist officeDuring your next dental appointment, you may be asked about more than your brushing and flossing habits. A recent survey found that 77 percent of dentists now perform substance abuse screenings as part of routine exams.

Why Are Dentists Are Worried About the Addiction Epidemic?

Dentists may not be considered primary care providers, but dental health plays a key role in your overall physical health. This puts dentists in a unique position to fight substance abuse.

Dentists often see patients who have tooth decay due to substance abuse issues. For example, methamphetamines are a leading cause of tooth decay and tooth loss. Alcohol abuse is a primary risk factor for oral cancer. Tobacco use leads to gingivitis and tooth loss.

Addressing the risk of substance abuse is also important because dentists are the second leading prescriber of prescription opioids. This puts them at risk of inadvertently starting someone on the path towards addiction or feeding the habit of someone who already has a full blown opioid use disorder. Drug interactions could be another potential concern, since prescription opioids given for pain relief after a dental procedure could have dangerous interactions when combined with alcohol or illegal street drugs.

What Do Substance Abuse Screenings Look For?

Substance abuse prevention efforts often start the moment a patient walks into the office. Staff members may be looking for signs of potential problems such as:

  • Poor personal appearance, including bloodshot eyes
  • Slurred words, unsteady movements, or other signs of current intoxication
  • A history of broken appointments
  • Repeated requests for unusual prescriptions based on a self-diagnosis
  • Dramatic complaints of severe pain not in line with the issue the patient is being seen for
  • Someone who arrives near closing time seeking opioid prescriptions with the promise to return for an appointment the following day

In addition to a more informal evaluation, the dental hygienist may ask the following questions:

  • How often do you consume alcoholic beverages in a typical week?
  • Have you used tobacco products such as cigarettes or smokeless tobacco in the past three months? If yes, how much and how often?
  • Have you used marijuana more than five times in your life? If yes, when was the last time you used marijuana?
  • Have you felt you should cut down or otherwise control your drinking or drug use?
  • Do you get angry, upset, or annoyed when people ask you about your alcohol or drug use?
  • Do you feel guilty about your drinking or drug use?
  • Have you ever needed a drink or used drugs immediately in the morning to calm your nerves or get rid of a hangover?

Female dentists are more likely to believe addiction screenings are part of their professional responsible than their male counterparts, with 61 percent of women and 52 percent of men conducting screenings.

Age is another factor in how dentists perceive the importance of addiction screening, with 62 percent of dentists over the age of 53 and 47 percent of dentists under the age of 53 conducting screenings.

What Happens Next?

Although the rise of addiction screenings at the dental office should be encouraged, screening people at risk of substance use disorders is only a small part of the battle.

A 2013 study in the Journal of the American Dental Association reports that most dentists who screen patients for substance abuse do not provide referrals to counseling or follow up with patients who exhibit warning signs of addiction. Despite their concern for the well-being of their patients, they feel unqualified or not prepared to offer more extensive drug use prevention services.

Providing continuing education opportunities and additional training to help dentists refer at-risk patients to the appropriate resources would be a cost-effective way to tackle the public health concerns associated with substance use disorders. Until then, however, it’s up to each individual to look out for the signs of addiction and urge friends, family, neighbors, colleges, and others in need to the appropriate evidence-based treatment programs.

Based in Port Matilda, Pennsylvania, St. Joseph Institute for Addiction provides detox and counseling to address the issues contributing to substance use disorders. Our faith-based approach views addiction as physical disease in need of treatment for the mind, body, and spirit. This allows for a solid foundation of sobriety, setting the stage for a future free from the burden of addiction.

By Dana Hinders

To learn more about our programs, please visit our website.

Related articles:

Medication assisted treatment MATMedication assisted treatment (MAT) for opioid addiction has been endorsed by the American Medical Association, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine. However, MAT is often misunderstood by those in search of effective recovery options.

What Medications Are Used to Treat Opioid Addiction?

The most common medications used to treat opioid addiction are:

  • Methadone
  • Buprenorphine (sold under the brand names Suboxone and Subutex)
  • Extended release naltrexone (sold under the brand name Vivitrol)

Both buprenorphine and methadone are classified as essential medicines by the World Health Organization. Methadone is given as an oral tablet, liquid, or wafer from licensed opioid treatment clinics only. Patients must visit the facility daily to receive treatment. Buprenorphine can be given as a tablet, a film placed under the tongue or against the inside cheek, or an implant inserted in the arm. Only specially credentialed doctors can prescribe buprenorphine.

Are There Any Side Effects?

Constipation and sweating are the most frequently reported side effects of treatment, followed by nausea, back pain, chills, weight gain, insomnia, and decreased libido. Side effects may decrease in severity as your body adjusts to the medication, but you should discuss any concerns about side effects with your healthcare provider.

The medications used to treat opioid addiction could interact with some prescription medications, such as SSRI antidepressants and those used to treat HIV. You will need to tell your healthcare provider about all of the medications you are currently taking to determine if medication assisted treatment is right for you.

Patients who suffer from liver disease require close monitoring white undergoing MAT.

Is MAT Safe for Pregnant Women?

MAT is considered safe for pregnant women, with much less risk to the unborn baby than continuing to abuse heroin or other opioids during pregnancy. Both methadone and buprenorphine will show up in a drug screen after a woman gives birth, but no action will be taken if your healthcare provider verifies that the medications are being used as part of your substance abuse treatment plan.

Since buprenorphine is a newer medication and has been the subject of less research, methadone is considered the standard choice for pregnant women. Buprenorphine is considered a Pregnancy Category C medication, which means the risk of adverse effects has not been ruled out.

After giving birth, women on low doses of methadone may be able to breastfeed. If you wish to breastfeed, this should be discussed with your healthcare provider.

How Long Does Medication Assisted Treatment Last?

The duration of MAT for opioid addiction is decided on a case-by-case basis. In most cases, the goal is to taper off the dosage slowly as you become more comfortable and confident in your sobriety. However, patients with a history of relapse can safely take their medication on a long-term basis if they are properly monitored.

There are three phases of MAT:

  • Induction: A medically monitored beginning of MAT, which occurs when the patient is in the early stages of withdrawal.
  • Stabilization: An adjustment of the dosage until the patient is reporting no cravings and experiencing few, if any, side effects.
  • Maintenance: When the patient is doing well with a steady dose of medication, options for ongoing recovery are discussed. This can include either tapering off the medication altogether or continuing indefinitely to prevent relapse.

Isn’t MAT Simply Substituting One Addiction for Another?

People who’ve struggled with opioid addiction are often leery of medication assisted treatment because they believe that it’s best to get sober without any pills in their system. However, the medications used for treating opioid addiction do not result in getting high. The dosage is intended only to reduce cravings and withdrawal symptoms by balancing the brain circuits affected by addiction. This gives your brain time to heal as you work towards recovery.

Medication assisted treatment does not interfere with cognitive functioning. This means you can work, attend school, care for your children, and enjoy relationships with friends and family while receiving treatment.

Can Medications Cure Opioid Addiction?

Treatment for opioid addiction should combine medications with counseling to address the underlying issues contributing to substance abuse. Medications on their own are not a sufficient treatment for addiction, but using medication assisted treatment has been proven to improve retention rates in counseling programs.

Addiction is a chronic illness, so someone who suffers from opioid addiction will never be fully cured in the traditional sense. However, treatment can help an addict learn to manage cravings to live a full and productive life.

By Dana Hinders