Safe Opioid Practice-Safe Opioid Practice

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Video Summary

Dr. Larry Williams presented a webinar on safe opioid prescribing in dentistry, drawing on his Navy, academic, and clinical experience. He opened with a humorous but serious story about a patient seeking Dilaudid after a tooth extraction, illustrating how some people misuse dental procedures to obtain opioids. He emphasized that fearful patients may manage with local anesthesia and nitrous oxide, while phobic patients often delay care until treatment becomes more invasive and painful.<br /><br />The lecture reviewed opioid history, how opioids act on brain receptors, and why they are risky—especially for younger patients whose brains are still developing reward pathways. Dr. Williams discussed common side effects, dependence, respiratory depression, constipation, and drug interactions. He also explained how some high-risk patients, occupations, and histories of substance abuse require extra caution. Prescription monitoring programs, patient screening, and exact written instructions were highlighted as essential safeguards.<br /><br />A major theme was that many dental pain cases do not require opioids. He recommended prioritizing NSAIDs and acetaminophen, including the FDA-approved dual-action combination of ibuprofen and acetaminophen (Advil Dual Action), which he praised as effective and practical. He also discussed preemptive analgesia and long-acting local anesthetics such as bupivacaine and Exparel to reduce postoperative pain and opioid need.<br /><br />Dr. Williams stressed responsible prescribing: no vague “PRN” directions, limited opioid quantities when necessary, reassessment for persistent pain, and referral to chronic pain specialists when appropriate. He also urged disposal of unused medications, use of drug take-back programs, and carrying naloxone (Narcan), which he described as a lifesaving reversal agent increasingly available over the counter.

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Safe Opioid Practice Larry N. Williams, DDS, MPH, MAGD, ABGD Subject: 340 Anesthesia and Pain Management Credits: 1.5 Audience: Dentists Fee: $125 (nonmembers); $75 (members); $37.50 (students) Description This lecture is intended to review the various aspects of pain management as they relate to opioids and their alternatives. It will also discuss how we as dentists can address abuse, misuse and disposal of opioid medications. Learning Objectives • Learn how to maintain a reasonable balance between providing appropriate pain management and minimizing the risk of misuse or abuse of opioids. • Be able to identify misuse or abuse and intervene effectively when it occurs. Speaker Bio Larry N. Williams, DDS, MPH, MAGD, ABGD, graduated from the University of Tennessee College of Dentistry in 1982 with subsequent service of 30 years in the U.S. Navy Dental Corps. After retirement, Williams began serving on the faculty at the Midwestern University College of Dental Medicine-Illinois as an associate professor working with preclinical dental students.

Keywords

safe opioid prescribing

dentistry

opioid misuse

NSAIDs

acetaminophen

ibuprofen combination

local anesthesia

nitrous oxide

naloxone

prescription monitoring

drug take-back programs