Opioid and Nonopioid Analgesic Prescriptions for Dental Visits in the Emergency Department, 2015–2017 National Hospital Ambulatory Medical Care Survey

Abstract

Introduction Prescription and nonprescription opioid misuse and the rising number of dental visits in emergency departments (EDs) are growing public health concerns in the US. Our study objective was to examine the relationship between prescription analgesics (opioids and nonopioids) and the type of ED visits (dental and nondental) at the national level. Methods We used data from the 2015–2017 National Hospital Ambulatory Medical Care Survey to examine the association between opioid, nonopioid, and combination of opioid and nonopioid analgesic prescriptions and dental and nondental visits in the ED. Covariates included socioeconomic variables, time of visit, provider type, triage level, hospital location (urban vs rural), and pain level. We conducted descriptive, bivariate, and multivariable analyses using weighted estimates. Results The final study sample included 57,098 ED visits from approximately 6 million dental and 414 million nondental visits to EDs during 2015–2017 nationally. Among dental visits, 20.8% received nonopioid analgesics (vs 23.4% among nondental visits), 36.6% received opioid analgesics (vs 14.0% among nondental visits), and 17.7% received both opioids and nonopioid analgesics (vs 8.7% among nondental visits). Adjusted multinomial logistic regression model indicated that, compared with nondental visits, dental visits had 4.8, 1.9, and 3.4 times higher likelihood of receipt of an opioid, nonopioid, or both opioid and nonopioid analgesic prescription, respectively, in the ED than no analgesic prescriptions. Conclusion Dental visits resulted in receipt of a significantly higher proportion of opioid prescriptions compared with nondental visits during 2015–2017. The study findings highlight the need for developing interventions to reduce opioid prescriptions in the ED, especially for dental visits.