Opioid Crisis
When addressing the opioid crisis that we are facing today, it is important to remember that there are both good and bad consequences of using opioids. Opioids were first used in the United States of America in the early 1860s as a method to treat wounded soldiers during the Civil War. Since then, many protective measures have been enacted to help prevent opioid overdoses and addiction. One of the main actions that was taken was the passing of the Controlled Substances Act in the 1970s which divides treatment options and medicines into different groups based on the likelihood of abuse (Georgetown Behavioral Health Institute, 2018). The general purpose of opioids is to provide pain relief and better overall quality of life. However, opioids can be very addicting and can lead to negative traits such as tolerance and/or dependence, overdose, and even death. Opioids can also cause negative side effects such as respiratory depression, nausea and constipation (Azadfard, 2023). Some alternative treatment methods for addressing oral pain management include nonsteroidal anti-inflammatory drugs (NSAIDS), topical ointments for localized pain, physical therapy (particularly for pain related to the TMJ and/or jaw muscles), and cognitive-behavioral therapy. There are several efforts at the state level to help combat the opioid crisis which include monitoring of prescription drugs, limiting prescription drugs, increased access/availability to Narcan, and treatment programs for patients (Azadfard, 2023).
I am currently working as a registered dental hygienist in Colorado Springs, CO. In Colorado, dental hygienists are allowed to administer some emergency drugs such as Narcan in certain circumstances. Many of the specific restrictions for administering emergency drugs are related to the presence of a licensed dentist in the building, having completed training for administration of the specific drug being used, and having completed current continuing education courses related to administration of emergency drugs (Justia Law, 2018). I think that it is very important for both dentists and dental hygienists to be able to administer emergency drugs. There are so many medical emergencies that can occur within the dental chair and/or dental office, so it is important for all employees to understand what to do in any of those situations—especially for dentists and dental hygienists. However, I also think that it is extremely important for individuals to be trained in the background and use of the specific emergency drugs prior to administration of the drug since there can be many severe consequences to the improper administration of drugs.
Part of the Surgeon General's 2015 report discusses general information regarding the nature of addiction, the impacts of addiction, and how to prevent, treat, and recover from addiction. The Surgeon General's report places emphasis on the fact that addiction can be a chronic brain disease. It also discusses the importance of prevention which is especially relevant as hygienists since I would consider a lot of our work to be prevention-focused (HHS, 2018). According to the Department of Health and Human Services, “In 2015, 66.7 million people in the United States reported binge drinking in the past month and 27.1 million people were current users of illicit drugs or misused prescription drugs. The accumulated costs to the individual, the family, and the community are staggering and arise as a consequence of many direct and indirect effects, including compromised physical and mental health, increased spread of infectious disease, loss of productivity, reduced quality of life, increased crime and violence, increased motor vehicle crashes, abuse and neglect of children, and health care costs.” (United States Department of Health and Human Services, 2016). Dental hygienists can end up seeing hundreds of patients per year and should complete a thorough oral cancer screening on each of those patients. After reading more of the Surgeon General’s 2015 report, it made me realized that we have a huge responsibility to impact and maybe even prevent other health crises. For example, if we notice that a patient has been taking opioids for a significant period, we can counsel our patients on the impacts of long-term opioid use and refer them to the primary care physician if needed. As dental hygienists, we do not have the authority or licensure to tell a patient to stop taking a specific medication, however we can have honest conversations with our patients which may lead them to pay more attention to their health.
References:
Azadfard, M. (2023, July 21). Opioid addiction. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK448203/
Georgetown Behavioral Health Institute. (2018). The origin and causes of the opioid epidemic. https://www.georgetownbehavioral.com/blog/origin-and-causes-of-opioid-epidemic#:~:text=A%20Brief%20History%20of%20Opioid%20Use%20in%20the%20US&text=The%20use%20of%20opioids%20to,the%20years%20following%20the%20war.
HHS. (2018). Facing addiction in America. https://www.hhs.gov/sites/default/files/OC_SpotlightOnOpioids.pdf
Justia Law. (2018). 2018 Colorado Revised Statutes. https://law.justia.com/codes/colorado/2018/title-12/health-care/article-35/part-1/section-12-35-124/
United States Department of Health and Human Services. (2016). Introduction and overview of the report. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. https://www.ncbi.nlm.nih.gov/books/NBK424860/
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