CommentaryOral pain and drug-seeking behavior
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Background
Oral-maxillofacial surgeons (OMS) are aware that some patients who come to their offices or are in emergency rooms complaining of severe dental pain are actually seeking prescriptions for potent narcotic analgesics. Often they claim to need immediate pain relief so they can seek appropriate care without the burden of pain. Typically they do not want the indicated therapy immediately or they come when the facilities for delivering the care are not open, such as evenings, weekends, and holidays.
ED Conditions
ED physicians are on the front line of managing patients who show drug-seeking behaviors. When such patients report pain in the lower back, neck, joints, ears, etc, ED physicians are able to analyze the situation and determine whether it merits treatment with a narcotic. However, when patients report oral pain, ED physicians may not have the training, proper imaging equipment, or time to evaluate the situation. Most ED physicians are not trained to perform local anesthesia, so they fall back on
Role for OMS
OMS can play an important role by offering resources to educate other practitioners and by advising hospital and urgent care administrators. Regular in-service training programs can be developed to educate community resources on the front line in providing care. ED physicians and nurses generally are eager to learn about how to better deal with common and difficult diagnostic and treatment situations, including patients who use dental pain reports to obtain drugs. The same approaches to
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Hupp JR: Emergency department bane—dental pain used to obtain narcotics. J Oral Maxillofac Surg 71:2009-2010, 2013
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