Leanne Teoh1, Wendy Thompson2, Colin C Hubbard3, Walid Gellad4, Kathryn Finn2, Katie J Suda4. 1. Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Carlton, Australia. Electronic address: leanne.teoh@unimelb.edu.au. 2. Division of Dentistry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom. 3. Department of Pharmacy Practice, College of Pharmacy, University of Illinois Chicago, Chicago, Illinois. 4. Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania; Division of General Internal Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Abstract
INTRODUCTION: Benzodiazepines contribute to substance use disorder and are often part of polydrug abuse, most frequently with opioids. Although dental opioid prescribing differs significantly between countries, little is known about the patterns of dental benzodiazepine prescribing. The aim of this study is to compare dental prescribing of benzodiazepines among the U.S., England, and Australia in 2013-2018. METHODS: Population-level data were accessed from national data sets for each country for dental benzodiazepine prescriptions. Outcome measures of dental benzodiazepine prescribing included: (1) prescribing rates by population for each year and (2) the quantity and relative proportion of benzodiazepines by type for each country. The analysis was conducted in 2020. RESULTS: Between 2013 and 2018, U.S. dentists prescribed 23 times more than English dentists and 7 times more than Australian dentists by population. During the study period, the rate of dental benzodiazepine prescribing decreased in England and the U.S. but increased in Australia. Despite these trends, U.S. dental prescribing rates remained 28 times more than English dentists and 6 times more than Australian dentists in 2018 (U.S., 3.10 prescriptions/1,000 population; England, 0.11 prescriptions/1,000 population; Australia, 0.50 prescriptions/1,000 population). U.S. dentists prescribed a wider variety of benzodiazepines than English and Australian dentists. Diazepam was most commonly prescribed in all countries. In the U.S., triazolam, lorazepam, and alprazolam were next most commonly prescribed. Temazepam was next most frequent in England and Australia. CONCLUSIONS: Significant variation in benzodiazepine prescribing rates and types were seen among the countries. To improve patient safety, further investigation into the appropriate use and choices of benzodiazepines in dentistry is needed.
INTRODUCTION: Benzodiazepines contribute to substance use disorder and are often part of polydrug abuse, most frequently with opioids. Although dental opioid prescribing differs significantly between countries, little is known about the patterns of dental benzodiazepine prescribing. The aim of this study is to compare dental prescribing of benzodiazepines among the U.S., England, and Australia in 2013-2018. METHODS: Population-level data were accessed from national data sets for each country for dental benzodiazepine prescriptions. Outcome measures of dental benzodiazepine prescribing included: (1) prescribing rates by population for each year and (2) the quantity and relative proportion of benzodiazepines by type for each country. The analysis was conducted in 2020. RESULTS: Between 2013 and 2018, U.S. dentists prescribed 23 times more than English dentists and 7 times more than Australian dentists by population. During the study period, the rate of dental benzodiazepine prescribing decreased in England and the U.S. but increased in Australia. Despite these trends, U.S. dental prescribing rates remained 28 times more than English dentists and 6 times more than Australian dentists in 2018 (U.S., 3.10 prescriptions/1,000 population; England, 0.11 prescriptions/1,000 population; Australia, 0.50 prescriptions/1,000 population). U.S. dentists prescribed a wider variety of benzodiazepines than English and Australian dentists. Diazepam was most commonly prescribed in all countries. In the U.S., triazolam, lorazepam, and alprazolam were next most commonly prescribed. Temazepam was next most frequent in England and Australia. CONCLUSIONS: Significant variation in benzodiazepine prescribing rates and types were seen among the countries. To improve patient safety, further investigation into the appropriate use and choices of benzodiazepines in dentistry is needed.
Authors: Joseph M Friedrich; Christie Sun; Xue Geng; Diane P Calello; Michael Gillam; Kaelen L Medeiros; Mark Smith; Bruce Ruck; Maryann Mazer-Amirshahi Journal: Clin Toxicol (Phila) Date: 2019-10-15 Impact factor: 4.467
Authors: Raymond G Hoffmann; Jane Morley Kotchen; Theodore A Kotchen; Terrie Cowley; Mahua Dasgupta; Allen W Cowley Journal: Clin J Pain Date: 2011 Mar-Apr Impact factor: 3.442
Authors: S L Calcaterra; S G Severtson; G E Bau; Z R Margolin; B Bucher-Bartelson; J L Green; R C Dart Journal: Clin Toxicol (Phila) Date: 2018-04-03 Impact factor: 4.467
Authors: Gloria C Mejia; Hawazin W Elani; Sam Harper; W Murray Thomson; Xiangqun Ju; Ichiro Kawachi; Jay S Kaufman; Lisa M Jamieson Journal: BMC Oral Health Date: 2018-10-26 Impact factor: 2.757
Authors: Kao-Ping Chua; Jennifer F Waljee; Vidhya Gunaseelan; Romesh P Nalliah; Chad M Brummett Journal: Am J Prev Med Date: 2022-03 Impact factor: 5.043