Abstract
The misuse of pharmaceutical opioids is a major public health issue. In Australia, codeine was re-scheduled on 1 February 2018 to restrict access; it is now only available on prescription. The aim of this study was to measure the change in dental opioid prescriptions, one year before and after the codeine re-scheduling in Australia and to assess dental prescribing rates of opioids for 2018 by population and by clinician. Data was extracted for dental opioids for the year immediately prior and after the codeine up-schedule (1 February 2017-31 January 2019) from the publicly-available national prescription database (Pharmaceutical Benefits Scheme). Descriptive statistics, T-tests and odds ratios were used to identify significant prescribing differences. Codeine, codeine/paracetamol, oxycodone and tramadol use increased significantly the year after the codeine restriction than the previous year (13.8–101.1%). Australian dentists prescribed 8.6 prescriptions/1,000 population in 2018, with codeine/paracetamol accounting for most prescriptions (96%). The significant increase in opioid prescribing highlights that Australian dentists may be contributing to the misuse of pharmaceutical opioids. Educational efforts should be targeted at the appropriate use of opioids and patient selection. Dentists should be added to the prescription monitoring system SafeScript so they can make informed decisions for patients who are potentially misusing opioids.
Highlights
The misuse of pharmaceutical opioids is a major public health issue
The Department of Health provides a national database on prescribed medicines in Australia that are recorded under the Pharmaceutical Benefits Scheme (PBS)[18]
PBS prescriptions account for approximately 75% of dispensed medicine use in Australia, where prescriptions are dispensed in hospital settings and outpatient pharmacies[19]
Summary
The misuse of pharmaceutical opioids is a major public health issue. In Australia, codeine was rescheduled on 1 February 2018 to restrict access; it is only available on prescription. The aim of this study was to measure the change in dental opioid prescriptions, one year before and after the codeine re-scheduling in Australia and to assess dental prescribing rates of opioids for 2018 by population and by clinician. The significant increase in opioid prescribing highlights that Australian dentists may be contributing to the misuse of pharmaceutical opioids. Dentists in Australia have increasingly been prescribing opioids; the most common product is codeine with paracetamol (Panadeine Forte)[11] This pattern continues despite non-steroidal anti-inflammatory drugs (NSAID) being more appropriate for dental pain[12,13]. Dental prescribing of opioids is increasing and some dentists are inappropriately preferencing the use of opioids over NSAIDs as recommended in the current Australian therapeutic guidelines[17]. There were two aims of this study: 1) to assess prescribing rates of dental opioids in 2018 and 2) to analyse the dispensed use of dental opioids, one year before and one year after the up-scheduling of codeine
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
