Prescription drugs: Dentists should be attentive for signs of potential misuse

By Dental Tribune International

Mon. 6. June 2016

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CANBERRA, Australia: Dr Chris Daly, chairperson of the Australian Dental Association’s Dental Therapeutics Committee, has issued a warning regarding potentially drug-seeking behaviour of patients. In order to prevent misuse, dentists should follow certain guidelines and be very cautious when receiving requests for prescriptions for benzodiazepines or opioids, he stressed.

In a note published in the current issue of the Australian Prescriber journal, Daly advised dentists to be suspicious of patients who wish to have drug-only treatment and either refuse or are not interested in non-drug treatment. Caution should also be exercised when patients identify drugs by name, or cannot recall or are unwilling to divulge the name and locality of their previous dentist.

According to Daly, requests for benzodiazepines generally involve new patients who claim to be very apprehensive about dental treatment and who may display anxiety characteristics during their dental examination. Those patients often inform the dentist that their previous dentist always prescribed “something to calm me down” and that it was “the only way that the dentist could do any work on me”, Daly wrote.

In order to distinguish the bona fide case from those seeking prescriptions for misuse, the note advised dentists to contact the patient’s previous dentist or medical practitioner, and prescribe one or two tablets only, rather than a full pack.

When facing a doubtful claim, Daly further suggested suitable responses to a patient seeking drugs. For opioids, the dentist may respond with the following answer: “The drugs you are seeking are not appropriate for your particular problem. I think you should discuss this with your medical practitioner (I could contact them if you like), or if your pain is very severe, perhaps you should attend hospital.” For benzodiazepines: “I do not prescribe the drugs you are seeking. I think you should discuss this with your medical practitioner (I could contact them if you like), or I could refer you to a specialist who manages anxious patients.”

According to data from the 2013 National Drug Strategy Household Survey, analgesics showed the largest increase in misuse among all drug types between 2010 and 2013 in Australia. In particular, 7.7 per cent of people in 2013 had used analgesics for non-medical purposes, compared with 4.8 per cent in 2010.