Policy statement on opioid abuse adopted by dental board

Despite cross-disciplinary efforts to reduce opioid addiction in the United States, almost 40 percent of Americans were using prescription painkillers in 2015, and approximately 2 million Americans reported a substance abuse disorder involving prescription pain relievers. In California alone, opioid-related deaths from 2002 to 2014 were up almost 30 percent. Dentists prescribe up to 12 percent of all opioid prescriptions in the U.S.

In light of these alarming statistics, the Dental Board of California in August 2017 finalized and adopted the following policy statement recognizing the epidemic of opioid abuse in the U.S. and encouraging the dental profession and consumers throughout the state to acknowledge the epidemic and actively participate in finding solutions to this issue:

“The [Board] recognizes that the widespread use and abuse of opioids in the country has risen to an epidemic level. The Board believes that educating both licensees and consumers on this important issue coincides with our mission of public protection. The Board therefore encourages its licensees to learn more about this epidemic and its tragic effects on individuals and their families and to understand best prescribing practices and patient education methods that can be used when prescribing opioids.”

The board plans to create a website resource of helpful links and educational resources for licensees and consumers to learn more about the epidemic.

ADA 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 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.

At the same time, ADA adopted a statement on the provision of dental treatment for patients with substance use disorders that encourages dentists to have a list of treatment centers in the area and consider keeping naloxone in the dental office.

CURES mandatory check requirements coming soon

Prescribers in California, including dentists with U.S. Drug Enforcement Administration registrations, are required to be registered in the state’s Controlled Substance Utilization Review and Evaluation System, known as CURES, and will soon be required to use the system when writing a prescription for Schedule II-IV medications.    

SB 482 by Sen. Ricardo Lara (D-Bell Gardens) requires all providers to consult a patient's electronic history in the CURES database before prescribing a controlled substance to a patient for the first time and at least once every four months thereafter when the prescribed controlled substance remains part of the patient's treatment. The law exempts providers from the requirement to check the CURES database if a nonrefillable five-day supply of a controlled substance is prescribed as part of a treatment for a surgical procedure the provider performed.

The law also includes a requirement that implementation begin after certification by the Department of Justice that CURES is fully operational; as the DOJ has not made that determination, implementation of this requirement has not yet begun.

Resource guide available at cda.org

CDA has an online resource guide to help dentists meet regulatory requirements and follow best practices for dental pain management, including reduced opioid prescribing. The guide lists links to many helpful educational resources including tutorials on how to register for and utilize CURES.

Questions and comments about opioid pain management resources or CURES registration may be directed to Mary McCune, CDA Public Affairs.

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California prescribers who are registered with the U.S. Drug Enforcement Agency to prescribe, dispense or administer controlled substances must also register to access the state’s prescription drug monitoring program, CURES. A $6 annual ($12 biennial) fee is assessed with licensure renewal in order to maintain the database.

“Your Guide to California Dental Practice Act Compliance” was updated in January 2017 to reflect new laws concerning adverse event reporting, scope of practice, required language in the anesthesia informed consent form, online advertising through Groupon, notice of licensure, prescriber dispensing of controlled substances and several other areas of practice.

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.