CDA offers new CURES and opioid resource guide

Although deaths from overdose of prescribed opioids have leveled off since 2009, they remain high. In California in 2014, prescription opioids were involved in the deaths of 2,024 people, according to California Department of Public Health data. The Centers for Disease Control and Prevention report that more than 15,000 people died nationwide from overdoses related to prescription opioids in 2015.

CDA has created a new online resource guide to help dentists meet requirements and follow best practices when prescribing opioids for the treatment of patients' dental pain. This resource is CDA's latest in ongoing efforts to address and combat California's opioid epidemic and ensure members have the most up-to-date information to maintain compliance in the dental practice.

Over the last two years CDA has held a prescription drug abuse lecture at CDA Presents The Art and Science of Dentistry; provided dedicated coverage on the science and practice of pain management in the CDA Journal; published numerous articles and updates about CURES on cda.org and in the CDA Update; and hosted a CURES webinar in collaboration with the Department of Justice. Links to these resources and others — including to ADA resources and relevant sections of the California Dental Practice Act — are now included on one easy-reference webpage at cda.org. CDA will expand and update the page with additional resources as they become available.

CURES, California's Controlled Substance Utilization Review Evaluation System, is the state's prescription drug monitoring program, which has also become more robust in the form of CURES 2.0. The 2.0 system offers dentists and other subscribers a streamlined application and approval process, stronger analytic and reporting functions and more information related to at-risk behavior. (See the related story on this page.)

ADA's statement on prescribing opioids for patients

The American Dental Association in October 2016 adopted and released a statement on the use of opioids to manage dental pain. The statement, provided here, outlines 10 best practices that dentists should follow, encompassing when to conduct a medical and dental history, recognition of multimodal pain strategies, what to cover in conversations with patients and more.
  1. When considering prescribing opioids, dentists should conduct a medical and dental history to determine current medications, potential drug interactions and history of substance abuse.
  2. Dentists should follow and continually review Centers for Disease Control and State Licensing Boards recommendations for safe opioid prescribing.
  3. Dentists should register with and utilize prescription drug monitoring program (PDMP) to promote the appropriate use of controlled substances for legitimate medical purposes, while deterring the misuse, abuse and diversion of these substances.
  4. Dentists should have a discussion with patients regarding their responsibilities for preventing misuse, abuse, storage and disposal of prescription opioids.
  5. Dentists should consider treatment options that utilize best practices to prevent exacerbation of or relapse of opioid misuse.
  6. Dentists should consider nonsteroidal anti-inflammatory analgesics as the first-line therapy for acute pain management.
  7. Dentists should recognize multimodal pain strategies for management for acute postoperative pain as a means for sparing the need for opioid analgesics.
  8. Dentists should consider coordination with other treating doctors, including pain specialists when prescribing opioids for management of chronic orofacial pain.
  9. Dentists who are practicing in good faith and who use professional judgment regarding the prescription of opioids for the treatment of pain should not be held responsible for the willful and deceptive behavior of patients who successfully obtain opioids for non-dental purposes.
  10. Dental students, residents and practicing dentists are encouraged to seek continuing education in addictive disease and pain management as related to opioid prescribing.
Find the CURES and opioid resource guide in the regulatory compliance section of CDA's website.

Related Items

CURES 1.0 will be discontinued on Sunday, March 5, 2017. The departments of Consumer Affairs and Justice have announced that beginning March 6 prescribing health care practitioners will only be able to access CURES 2.0. To securely access CURES 2.0, dentists will need to update their web browsers as specified.