The study's objective was guideline use to limit
prescriptions to patients more likely to abuse opioids.
In analyzing the effectiveness of the guidelines,
researchers observed all patients aged 16 years and older
who were discharged with a diagnosis of a painful dental
condition. Patients were excluded if they had objective
evidence of dental pain, such as being admitted,
transferred, received intravenous antibiotics or had an
oral incision and drainage procedure.
Program leaders observed a 17% absolute reduction in
departmental opioid prescription rate for ED patients
discharged with painful dental conditions. However, in
relative (not absolute) terms, opioid prescription
Comparing data for one year prior to guideline
implementation with the following year, the proportion of
ED and urgent care visits accounted for by patients
claiming dental pain fell from 26 to 21 per 1,000 visits.
This 19% decrease is most likely attributed to
word-of-mouth conversations about the new prescription
restrictions among patients that used pain, theft, or
loss to access opioid prescriptions.
Further information on program results:
Fox, T.R., Li, J., Stevens, S. and Tippie, T. (2013). A
performance improvement prescribing guideline reduces
opioid prescriptions for emergency department dental pain
patients. Annals of Emergency Medicine, 62(3),
Case study. The Centers for Disease Control and
Prevention's March 2018 Rural Health Policy Brief,
Opioid Overdoses In Rural America."