Across the country, the number of opioid deaths continue to rise. In 2017, the state of Wisconsin saw more than 900.
Changes are being implemented in an effort to lessen the number of people addicted. United Healthcare made changes to its opioid policy when it comes to prescriptions being written by dentists for people under the age of 19. The scripts are now limited to a three day supply and no more than 50 morphine milligrams a day.
Doctor Ted Wong is the Chief Dental Officer for United HealthCare. He says according to data, while dentists with United HealthCare only write about 12 percent of the opioid prescriptions, that percentage is much higher when broken out by age group.
“For the teenagers and young adults, dentists write about 45 percent of those opioid prescriptions like Vicodin, Percocet and codeine,” Wong says.
However, Wong notes there’s a good explanation for why UHC dentists write so many opioid scripts for young people — they’re having their wisdom teeth removed. Still, he says it’s problematic to introduce such addictive drugs to young people.
“They’re brains are still maturing so they’re even more susceptible to the addictive effects of opioids. And this is an age group that is more likely at higher risk to misuse or abuse,” Wong explains.
While pain management is important, there are alternatives to opioids.
“In some cases, using a combination of Tylenol with Motrin, together, can be as effective or more effective than opioids without the risk of the addiction that comes with opioids,” Wong says.
If an opioid is needed, people ask about the lowest dose necessary according to Wong. He stresses what he calls the "three b’s" — be informed, be involved and be careful.
Associate professor of Family Medicine at UW-Madison, Aleksandra Zgierska, agrees that there is a problem with opioid abuse in the U.S., but she has concerns about blanket policies that don't take the patient clinician relationship into account.
“While there could be positive aspects to these policies, there also could be unintended consequences and that’s what typically we worry about,” she notes.
Earlier this month 180 medical professionals throughout the state were put on notice that they were prescribing more opioids than their peers. Zgierska believes medical professionals will feel threatened, which she says is not helpful.
“We all are worrying about our licenses, are we doing the right thing? We hear on the media that opioids are villains nowadays. So the pressure is tremendous to keep reducing the prescribing of opioids and while in a bigger picture responsible opioid prescribing is a really good target," says Zgierska. "We shouldn’t push this pendulum so far that we might sometimes do things that may not actually have evidence base."
Data from Wisconsin shows that simply lessening the number of opioid prescriptions doesn’t mean fewer users according to Zgierska. She says reductions in prescribing has not led to reductions in the number of people being seen in emergency rooms because they’ve overdosed.
Zgierska says what really needs to happen is a multifaceted approach with the goal of appropriately prescribing opioids and monitoring patients, which will lead to fewer prescriptions.