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Secobarbital · Skeletal muscle relaxants o Carisoprodol · Non‐benzodiazepine hypnotics o Chloral Hydrate o Eszopiclone o Meprobamate o Suvorexant o Zaleplon o Zolpidem Dental Guideline on Prescribing Opioids for Acute Pain Management Adopted by the Bree Collaborative, September 27th, 2017 Page 8 of 12 Appendix B: American Dental Association Statement on the Use of Opioids in the Treatment of Dental Pain 1. When considering prescribing opioids, dentists should conduct a medical and dental history to determine current medications, potential drug interactions and history of substance abuse. 2. Dentists should follow and continually review Centers for Disease Control and State Licensing Boards recommendations for safe opioid prescribing. 3. Dentists should register with and utilize a prescription drug monitoring program (PDMP) to promote the appropriate use of controlled substances for legitimate medical purposes, while deterring the misuse, abuse and diversion of these substances. 4. Dentists should have a discussion with patients regarding their responsibilities for preventing misuse, abuse, storage, and disposal of prescription opioids. 5. Dentists should consider treatment options that utilize best practices to prevent exacerbation of or relapse of opioid misuse. 6. Dentists should consider nonsteroidal anti‐inflammatory analgesics (NSAIDs) as the first‐line therapy for acute pain management. 7. Dentists should recognize multimodal pain strategies for the management of acute postoperative pain as a means of sparing the need for opioid analgesics. 8. Dentists should consider coordination with other treating doctors, including pain specialists, when prescribing opioids for management of chronic orofacial pain. 9. Dentists who are practicing in good faith and who use professional judgment regarding the prescription of opioids for the treatment of pain should not be held responsible for the willful and deceptive behavior of patients who successfully obtain opioids for non‐dental purposes. 10. Dental students, residents and practicing dentists are encouraged to seek continuing education in addictive disease and pain management as related to opioid prescribing. ADA House of Delegates Adopted: October 2016 Dental Guideline on Prescribing Opioids for Acute Pain Management Adopted by the Bree Collaborative, September 27th, 2017 Page 9 of 12 Appendix C: Special Considerations for Patients with Substance Use Disorder Patients with substance use and/or psychiatric disorders are more likely to have complications from opioid use, such as misuse, abuse or overdose.1‐ 32 1. Help patients prevent opioid misuse or relapse by prescribing opioids only when indicated, and avoid opioids at patient request. Support patients who have made a commitment to a drug‐free lifestyle and take precautions when considering prescribing opioids. 2. Use validated instruments to assess predictors of suboptimal recovery, such as depression, fear avoidance, and catastrophizing, which can lead to persistent pain and functional limitation. Instruments are available here. 3. Be knowledgeable of community resources for treatment of substance use disorders and be prepared to make referrals: Washington Recovery Help Line. 4. Complete the ADA opioid continuing education (CE) webinar and review educational materials on managing dental pain: a. Safe Opioid Prescribing for Acute Dental Pain. Two‐hour CE class from Boston University: