title: A Model for Opioid Risk Stratification: Assessing the Psychosocial Components of Orofacial Pain.
abstract: This article describes a model of opiate risk stratification with a special focus on dentistry and oral surgery. A brief overview covers the scope of the US opioid abuse and misuse epidemic, and the role of the dentist in mitigating the problems of diversion and misuse of controlled substances. The expanding role of dentistry is summarized. An assessment outlines gathering critical risk information, screening questionnaires, access to state prescription monitoring programs, and communication with cotreating providers. Special populations are discussed. Barriers and possible solutions for effective implementation of these strategies are summarized.
authors.affiliation: Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts School of Dental Medicine, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: rkulich@mgh.harvard.edu.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Kulich
authors.affiliation: Boston Pain Care Center, Waltham, MA, USA.
authors.forename: Jordan
authors.initials: J
authors.lastname: Backstrom
authors.affiliation: Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts School of Dental Medicine, Boston, MA, USA; Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Brownstein
authors.affiliation: Department of Biostatistics and Experimental Design, Tufts University School of Dental Medicine, 1 Kneeland Street, 7th Floor, Boston, MA 02129, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Finkelman
authors.affiliation: Department of Diagnostic Sciences, Craniofacial Pain and Headache Center, Tufts School of Dental Medicine, Boston, MA, USA.
authors.forename: Shuchi
authors.initials: S
authors.lastname: Dhadwal
authors.affiliation: Department of Diagnostic Sciences, Boston Pain Care, Tufts School of Dental Medicine, Boston, MA, USA.
authors.forename: David
authors.initials: D
authors.lastname: DiBennedetto
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy* / Q000523:psychology*; D005157:Facial Pain / Q000188:drug therapy* / Q000523:psychology*; D006801:Humans; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000517:prevention & control*; D059408:Pain Management; D010147:Pain Measurement; D018570:Risk Assessment; D012307:Risk Factors; D015813:Substance Abuse Detection; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid
keywords: Dentistry; Interprofessional; Opioid; Risk-management; Substance abuse