New Opioid Prescribing Policy for Colorado Dentists

Molly Pereira Featured News

September 30, 2014

In July, the State Board of Dentistry adopted a new policy aimed at reducing prescription drug abuse by better managing opioid prescribing. In short, the policy states that providers prescribing and/or dispensing opioids should:

  • Be informed about evidence-based practices for opioid use in healthcare and risk mitigation;
  • Collaborate with the integrated healthcare team to decrease over-prescribing, misuse and abuse of opioids; and
  • Follow common guidelines:
    • Before prescribing or dispensing (including use of the Colorado Prescription Drug Monitoring Program (PDMP));
    • When prescribing or dispensing;
    • When prescribing or dispensing for advance dosage, formulation or duration;
    • When implementing patient education (including discussions on appropriate use, storage and disposal of opioids, as well as risks and the potential for diversion); and
    • When discontinuing opioid therapy.

A threshold level of greater than 120 mg of morphine equivalents per day was established as a level where prescribers should put in place additional safeguards, including consultation with pain management specialists and treatment plan enhancements (such as utilizing a treatment agreement with the patient). 90 days was determined as an advised threshold for treatment duration, after which pain and risk assessments should be conducted and specialists should likely be consulted.

Dentists are the second highest prescribers of opioids in the U.S. Statistics show that many dentists who prescribe opioids expect patients to have leftover drugs, which can be a major source for abuse. While nearing the thresholds set in Colorado’s opioid prescribing policy is unusual for most dentists, dentists should familiarize themselves with the policy and consider the policy’s guidance when prescribing opioids, including prescribing at the lowest effective dose and quantity. View the full opioid prescribing policy here.

The Colorado Medical Board, the Colorado State Board of Nursing, the Colorado Board of Pharmacy, and the Colorado State Board of Dentistry all collaborated on the policy and adopted it jointly. The State Boards of Optometry and Podiatry subsequently adopted the policy, and the State Board of Veterinary Medicine also endorsed it, accounting for all prescribers of controlled substances in Colorado.