I learned a ton of valuable information in dental school, but something I didn’t pick up on was how many drug seekers I’d see in my practice. Holy moly!
We know that prescription drug abuse is the fastest growing and most prevalent drug problem in the US, and many seekers use dentists as a resource for the drugs. This has to stop—most importantly for the benefit of the abusers, but nearly equally as beneficial for us as practitioners. It’s a waste of my chair time and staff effort for someone to come into my office, who’s clearly not interested in treatment and only wants something “to hold them over until they come up with the money.” The only way we can combat this issue is as a team. I’m here to give you a few resources for your arsenal the next time you’re presented with such a case.
You know these patients. They’re smart individuals, for the most part. Their medical histories are dead giveaways:
Allergic to: Codeine, Hydrocodone, Tramadol
There’s often an infection, broken tooth, half treated root canal with a temporary filling or, on occasion, no visible issue. Their pain level is through the roof and they often jump out of the chair the second you touch their lip with a mirror. And they usually have the same spiel:
“Doc, I can only have that one that starts with a ‘O’… Ox… Oxy… Oxycontin I believe is what it’s called.” or “P… Per… Perco something or another.”
Please tell me you’re not fooled by this. If so, I have news for you: there are state prescription monitoring programs! Most states have some variation, and 25 states share their information through a program titled PMP Interconnect, sponsored by the National Association of Boards of Pharmacy (NABP). In Virginia, it’s linked through the Dept of Health Professions. Are you wondering how this is useful to you?
My staff is so well versed in this program. With a single red flag, even during the initial phone conversation, they log in, enter the patient’s information, and out comes their prescription history. It takes 2 minutes, is available 24/7 and is all done online. Sometimes the list of prescriptions is upwards of 10 pages long! THIS patient is getting no prescriptions from me beyond Ibuprofen or an antibiotic. I even bring the print out into the operatory with me when I have pushback from patients about my unwillingness to prescribe. Some have gotten right out of the chair and walked out. So be it.
The problem is that these individuals “doctor shop.” They leave my office after an unsuccessful attempt at gaining a pain medication and drive right down the road to the next office. My hope is that with education and more practitioners paying notice to the issue, we can help combat this major problem.
If you’re looking for more information, there a few great resources that offer free CE on the subject. Check out the FDA, NIDA and Boston University School of Medicine.
Thanks for listening.
Donald Murry, DMD