You’ve completed the mandatory DEA MATE training. Now, it’s time to build on that foundation. As a dental professional, your role in identifying and preventing the misuse of prescription drugs is critical. This guide offers practical steps and insights to help you confidently manage situations involving potential prescription drug abuse in your practice. By staying informed, you can protect your patients, your practice, and the wider community.
Recognizing the signs of drug-seeking behavior
Identifying patients who may be misusing or diverting dental prescription drugs is the first step. While one sign alone is not definitive, a pattern of behavior can indicate a problem. Stay alert for patients who exhibit specific tactics or characteristics.
Related CE course for dental professionals: Prescription Drug Abuse Among Dental Patients: Scope, Prevention, and Management, 3rd Ed
Common patient behaviors
Drug-seeking individuals often present with a sense of urgency. They might:
- Arrive near closing time or call after hours.
- Claim to be from out of town and without a regular dentist.
- Provide a vague or inconsistent health history.
- Be unwilling to share their primary care provider’s contact information.
- Pressure you for specific drugs, especially opioids.
- Claim their medication was lost, stolen, or “didn’t work.”
These behaviors are designed to rush your decision-making. Taking a moment to assess the situation is crucial.
Tactics and characteristics
Patients attempting to acquire drugs fraudulently may display distinct behaviors in the office. Look for:
- Unusual assertiveness or mood disturbances.
- Textbook symptoms that seem rehearsed or exaggerated.
- A lack of interest in the actual diagnosis or treatment plan.
- Reluctance to undergo an exam or provide references.
- Physical signs of drug abuse, such as marks on the skin.
Recognizing these patterns helps you approach the situation with appropriate caution and professionalism.
Related CE course for dental professionals: Responsible and Effective Opioid Prescribing
Taking action: A step-by-step approach
When you suspect a patient is misusing dental prescription drugs, a structured response is essential. A thoughtful plan ensures you handle the situation effectively while adhering to legal and ethical standards.
1. Update your health history forms
Your first line of defense is a comprehensive patient health history. Your intake forms should include direct questions about both past and current prescription drug use. Also, ask about alcohol and illicit drug use. This information provides a baseline and opens the door for a conversation if needed. A thorough history is a vital tool for making informed prescribing decisions.
2. Use screening tools
Several validated screening tools can help you assess a patient’s risk for substance abuse. Integrating one of these into your practice can provide objective data. Consider using tools like:
- SBIRT (Screening, Brief Intervention, and Referral to Treatment)
- DAST-10 (Drug Abuse Screening Test)
- CAGE (Substance Abuse Screening Tool)
Decide who on your team will administer the screening and establish a clear protocol for addressing positive results. This preparation makes the process smoother and more effective.
3. Educate your team and patients
Everyone in your practice has a role to play. Educate your entire dental team on the signs of prescription drug abuse and the office’s protocols. Ensure that they know how to respond to difficult situations with professionalism and empathy.
Patient education is just as important. Discuss the risks of opioid medications and the importance of secure storage. Advise patients to take medications only as directed and to be honest with all their healthcare providers about what they are taking.
4. Collaborate with other healthcare professionals
Building a network with local pharmacists and physicians is invaluable. Collaborative Practice Agreements, or even informal partnerships, create a united front against prescription drug diversion. A quick call to a patient’s primary care physician or local pharmacy can confirm their medication history and prevent “doctor shopping” or “pharmacy shopping.” This teamwork protects the patient and the community.
5. Prioritize non-opioid pain management
Current guidelines recommend non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen as first-line treatments for most dental pain. These non-opioid options can provide relief that is comparable or even superior to opioids without the risk of abuse.
For patients with a known or suspected history of substance abuse, avoid prescribing opioids. Instead, focus on alternatives and consult with their physician or pharmacist to coordinate care and facilitate a treatment referral if necessary. Administering long-acting local anesthetics before dismissal can also help manage post-procedure pain effectively.
Your role in curbing the epidemic
As a dental professional, you are uniquely positioned to identify at-risk individuals and prevent the diversion of dental prescription drugs. By implementing these strategies, you strengthen your practice’s defenses against drug abuse and contribute to a healthier community. Stay educated, remain vigilant, and use the resources available to you. Your efforts can make a significant difference in a patient’s life and help turn the tide on the prescription drug crisis.
Bookmark helpful resources like SAMHSA’s Behavioral Health Treatment Services Locator on your office computers. Having this information ready allows your team to refer patients to local treatment centers quickly and efficiently.
