Oral Health Program: Opioids and Substance Use Disorders

There are two options available for viewing the interactive data dashboard. To shift between views, please use the "View Trends" or "View Map" option located in the top right corner.
Filter data by year: Use the "Select Year" dropdown menu located in the upper left corner.
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Filter data by county: Use the "Select County" dropdown menu located in the upper right corner of the "View Trends" option.

Data were sourced from the Prescription Drug Monitoring Program (PDMP) database using only opioid prescriptions written by dental providers from 2013-2021. Data suppression was used to protect provider confidentiality. Data suppression was enforced for any county with a single prescriber within a given year. For example, if County X had one prescriber in 2013 and two prescribers in 2014, then its 2013 data would be excluded from the dashboard, but its 2014 data would be included. Measures included in the dashboard represent yearly averages by county. See description of each measure outlined below.

• Prescriptions per Prescriber: Average number of prescriptions written by prescribers
• Days Supply per Prescription: Average number of days a prescription would last written by prescribers
• Morphine Milligram Equivalents (MMEs) per Prescription: Average number of MMEs per prescription written by prescribers
• Daily Dosage per Prescription (MMEs/Day): Average daily dosage per prescription written by prescribers

Did you know?

• Opioids are not necessary for most dental pain, even surgical tooth extraction.
• Research shows there are safer alternatives to prescribing opioids for relief of oral pain: NSAIDs, which are generally safe for short term pain relief, are recommended for first-line therapy.
• Wis. Admin. Code DE 13.03 (1m), requires a minimum of two hours of continuing education for dentists on the topic of responsible prescribing and the DEA requires 8 hours of training on safe controlled substance prescribing. Comprehensive Approach to Dental Pain Management in the Evolving Substance Use Disorder Epidemic, a 2-part DHS training offered at no cost to participants, applies to both requirements.
• Prescribers should check the Wisconsin Enhanced Prescription Drug Monitoring Program (ePDMP) before writing prescriptions for controlled substances, and enter appropriate information into it once a prescription is provided. Registering a delegate may simplify this process.

More resources

• DEA MATE Act SUD Educational Package American College of Medical Toxicology (ACMT): Paid education to satisfy eight-hour training requirement on the treatment and management of opioid or other substance use disorders for DEA-licensed dentists, excluding those in exclusive veterinary practice, as outlined—DEA specific guidance for health care providers.
• Opioids and Children and Adolescents: Information for Oral Health Professionals – National Maternal and Child Oral Health Resource Center publication: Describes recent research and best practices for pain management in children and adolescents, and where to find more evidence-based resources.
• Oral Analgesics for Acute Dental Pain – ADA: Provides information on managing acute dental pain with nonopioid analgesic options. The section on Selecting an Acute Pain Management Strategy provides a table of anticipated post procedural pain levels and a table of oral analgesic options for treating acute dental pain based on pain level from mild to severe.
• Prescribing Opioids for Women of Reproductive Age: Information for Dentists – National Maternal and Child Oral Health Resource Center publication: Describes best practices for pain management in pregnant women, guidelines for prescribing opioids, and a description of neonatal opioid withdrawal syndrome.
• Wisconsin Dentistry Examining Board Best Practices for Prescribing Controlled Substances Guidelines (PDF) – Wisconsin Department of Safety and Professional Services (DSPS) publication: This publication is Wisconsin Dentistry Examining Board's legal guidance to dentists for prescribing controlled substances.
• Wisconsin Enhanced Prescription Drug Monitoring Program – DSPS: The ePDMP tool helps combat the ongoing prescription drug abuse epidemic in Wisconsin, provides valuable information about controlled substance prescriptions dispensed in the state; aids healthcare professionals in their prescribing and dispensing decisions; and fosters the ability of pharmacies, healthcare professionals, law enforcement agencies, and public health officials to work together to reduce the misuse, abuse, and diversion of prescribed controlled substance medications. Remember, register a delegate and simplify your process for checking the ePDMP before writing a patient prescription.

Did you check the Wisconsin ePDMP?

People, Health, Dignity, Respect

Respecting a person's health and dignity can happen through conversation. Some conversations may feel difficult, but avoiding stigmatizing language, using trauma-informed practices, and motivational interviewing techniques can help.

Showing support and having hard conversations

Wisconsin Oral Health Program created a two part online training to help the entire oral health care team show support and address hard conversations with patients or a team member surrounding Opioid use or SUD.

Learn more about the trainings:

• Substance Use Disorders: Showing Support and Having Hard Conversations Part 1

• Substance Use Disorders: Showing Support and Having Hard Conversations Part 2

Words matter - guide for choosing your words

Anyone may use substances, use illegal drugs, or misuse prescription medications when they are seeking pain relief or still experiencing cravings. Understanding that people are people first and avoiding stigmatizing language is one way to show respect.

Don’t say this: Addict, junkie, drunk, pill popper, pill head
Say this instead: Person with a substance use disorder, Person with a ____(e.g., alcohol, benzodiazepine, chemical, opioid, etc.) use disorder

Don’t say this: Dirty UA, dirty drug screen
Say this instead: Positive drug screen

Don’t say this: Drug abuse
Say this instead: Drug use, substance use, medication misuse

Don’t say this: Drug-seeking
Say this instead: Still experiencing cravings, seeking pain relief

Don’t say this: Ex-addict, former addict
Say this instead: Person in recovery, person in remission

Don’t say this: Habit
Say this instead: Substance use disorder,____ (e.g., alcohol, benzodiazepine, chemical, opioid, etc.) use disorder

Don’t say this: Reformed addict
Say this instead: Previously used ____ (e.g., alcohol, benzodiazepines, chemicals, opioids, etc.), in recovery, in remission

Don’t say this: Relapsed, slipped
Say this instead: Returned to use

Don’t say this: Stayed clean
Say this instead: Maintained recovery

• Introduction to Motivational Interviewing – University of Wisconsin (UW) Health training – 1 CE credit: Motivational Interviewing (MI) is a collaborative, goal-oriented style of communication with particular attention to the language of change. It is designed to strengthen personal motivation for, and commitment to, a specific goal by eliciting and exploring the person's own reasons for change within an atmosphere of acceptance and compassion. With the use of modules and skill building, this course provides an introduction to MI, followed by the Foundation and Four Processes of MI.
• Introduction to Trauma Informed Care (TIC) – Department of Health Services (DHS) and UW training: This learning module defines and identifies types of trauma, explains the significance of the Adverse Childhood Experiences study and its impact in the advent of TIC, explains resilience and resilience concepts, defines TIC, recognizes the five principles of TIC culture, and differentiates between traditional substance use disorder recovery practices and trauma-informed recovery practices.

• Dose of Reality: Resources for Professionals – DHS: More information on Wisconsin's opioid epidemic and prevention, getting help now, data, and additional resources for professionals.
  • Learn where naloxone/NARCAN® is available in your community.
  • Learn where fentanyl test strips are available in your community.
• Oral Health, Mental Health and Substance Use Treatment: A Framework for Increased Coordination and Integration – National Council for Mental Wellbeing: "Challenges with oral health, mental health and substance use are exceedingly common in the United States and contribute heavily to the burden of disease in the nation." Toolkit provides a guide for health professionals to increase coordination and integration efforts across oral, mental health, and substance use treatment settings; offers suggestions, strategies, and on-the-ground examples for implementation of new care models across health systems.
• Substance Abuse and Mental Health Services Administration (SAMHSA) – U.S. Department of Health and Human Services: SAMHSA leads public health efforts to advance the behavioral health of the nation. Use this website to locate information about treatment options, practitioner training, public messages, grant funding opportunities, data, programs, news and more.
• Substance Use: Provider Information – DHS: A webpage for health care professionals who provide substance use disorder services and are seeking support and direction to treat patients with substance use issues. Find information on hotlines, data, rules and regulations, and professional training opportunities.