Dentists routinely prescribe opioids for patients 18 years old or younger, a trend that can open the door to potential misuse, diversion, and addiction, according to a new study from the American Dental Association. Although dentists comprise only 8 percent of all opioid prescribers in the U.S., they account for the highest number of prescriptions to young people. And while an overwhelming majority of dentists surveyed said that a combination of nonsteroidal anti-inflammatory drugs such as ibuprofen and acetaminophen are equally or even more effective than opioids, 43 percent still reported regularly prescribing opioid medications. The focus on those under 18 is particularly worrying, the report noted, because the first exposure to opioids for many people occurs in their teens following common dental procedures like third molar extractions.
Meanwhile, as more states legalize both recreational and medical marijuana its use during pregnancy is increasing, along with the potential for abuse or dependence. A new study from Columbia University and Well Cornell Medicine captured the magnitude of marijuana use among prenatal hospitalizations, finding that the proportion of pregnant patients with cannabis use disorder—defined as cannabis use with clinically significant impairment or distress—rose 150 percent between 2010 and 2018. Researchers say legalization has likely lessened fears about the risks of using marijuana during pregnancy, leading many patients to consume cannabis instead of prescribed medications, thinking it’s a safer choice. Physicians recommend against using cannabis while pregnant, chiefly because of both known and unknown fetal effects such as low birth weight and other adverse outcomes.
And finally, an commentary in the Wall Street Journal looks at the issue of allowing truck drivers to get behind the wheel while taking medications routinely prescribed to treat opioid use disorder, such as methadone and buprenorphine. The authors argue that in the face of a trucker shortage that is exacerbating supply chain woes, drivers should be permitted to hit the road, and not have their licenses revoked, as some states have done. Federal regulations offer no clear guidance, but studies show that patients who start on these medications can experience sedation and cognitive impairment as their doses are stabilized, and then rapidly adapt within a few weeks. Still, it may be difficult to closely monitor the condition of such patients, which may fluctuate, and therefore poses a possible risk to other drivers.