A Model for Opioid Risk Stratification: Assessing the Psychosocial Components of Orofacial Pain

Ronald J Kulich; Jordan Backstrom; Jennifer Brownstein; Matthew Finkelman; Shuchi Dhadwal; David DiBennedetto

doi:10.1016/j.coms.2016.03.006

A Model for Opioid Risk Stratification: Assessing the Psychosocial Components of Orofacial Pain

Oral Maxillofac Surg Clin North Am. 2016 Aug;28(3):261-73. doi: 10.1016/j.coms.2016.03.006.

Authors

Ronald J Kulich¹, Jordan Backstrom², Jennifer Brownstein³, Matthew Finkelman⁴, Shuchi Dhadwal⁵, David DiBennedetto⁶

Affiliations

¹ Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts School of Dental Medicine, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: [email protected].
² Boston Pain Care Center, Waltham, MA, USA.
³ Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts School of Dental Medicine, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Biostatistics and Experimental Design, Tufts University School of Dental Medicine, 1 Kneeland Street, 7th Floor, Boston, MA 02129, USA.
⁵ Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts School of Dental Medicine, Boston, MA, USA.
⁶ Department of Diagnostic Sciences, Boston Pain Care, Tufts School of Dental Medicine, Boston, MA, USA.

PMID: 27475506
DOI: 10.1016/j.coms.2016.03.006

Abstract

This article describes a model of opiate risk stratification with a special focus on dentistry and oral surgery. A brief overview covers the scope of the US opioid abuse and misuse epidemic, and the role of the dentist in mitigating the problems of diversion and misuse of controlled substances. The expanding role of dentistry is summarized. An assessment outlines gathering critical risk information, screening questionnaires, access to state prescription monitoring programs, and communication with cotreating providers. Special populations are discussed. Barriers and possible solutions for effective implementation of these strategies are summarized.

Keywords: Dentistry; Interprofessional; Opioid; Risk-management; Substance abuse.

Publication types

Review

MeSH terms

Analgesics, Opioid / therapeutic use*
Chronic Pain / drug therapy*
Chronic Pain / psychology*
Facial Pain / drug therapy*
Facial Pain / psychology*
Humans
Opioid-Related Disorders / epidemiology
Opioid-Related Disorders / prevention & control*
Pain Management
Pain Measurement
Risk Assessment*
Risk Factors
Substance Abuse Detection
Surveys and Questionnaires
United States / epidemiology

Substances

Analgesics, Opioid