Researchers Investigate the Prevalence of Gingivitis During Pregnancy

Posted on June 24, 2016

Seoul, Republic of Korea – This week at the 94th General Session & Exhibition of the International Association for Dental Research, researcher Michael Reddy, University of Alabama at Birmingham, USA, presented a study titled “Gingivitis During the First/Second Trimesters of Pregnancy.” The IADR General Session is being held in conjunction with the 3rd Meeting of the IADR Asia Pacific Region and the 35th Annual Meeting of the IADR Korean Division.

This investigation evaluated the effects of gestational age, study site, and demographic factors on first and second trimester pregnancy gingivitis using baseline data from a large multicenter study. Screening was conducted to identify pregnant women between 8-24 weeks of gestational age with at least 30 gingivitis bleeding sites. Trained examiners measured whole mouth gingivitis scores at up to 168 sites using a standard 4-point clinical index (Loe-Silness GI), and bleeding site counts were determined by subject. Using baseline values, regression analysis was used to analyze the natural history of gingival inflammation during the late first trimester through the second trimester of pregnancy.

For this study, 817 women were screened. Baseline gingivitis measures were collected on 746 women, and 666 evaluable women with 30+ bleeding sites were included in this baseline analysis. Mean gestational age at gingivitis examination was 17.1 weeks, while maternal age averaged 27.8 years, ranging from 18 to 46. The gingival inflammation mean was 51.2 sites, ranging from 30 to 144. From the regression analysis, study site and maternal age were significant factors in gingival bleeding. Centers differed by 4.0 gingival inflammation and younger women presented with higher measured gingival inflammation. Gestational age and ethnicity were not significant factors in gingival bleeding during the first and second trimesters of pregnancy.

Clinical examination of 600+ pregnant women showed moderate-to-severe gingivitis to be common, well established, and relatively stable in the late first and second trimester, and regular dental care prior to and during pregnancy may be critical to maintaining oral health.

This study was funded by a grant from the Procter and Gamble Company (#2011001).

 

Effectiveness of Silver Diamine Fluoride in Arresting Root Caries in Different Fluoridated Areas

Posted on June 24, 2016

Seoul, Republic of Korea – Today at the 94th General Session & Exhibition of the International Association for Dental Research, researcher Edward Lo, University of Hong Kong, SAR, China, will present a study titled “Effectiveness of SDF in Arresting Root Caries in Different Fluoridated Areas.” The IADR General Session is being held in conjunction with the 3rd Meeting of the IADR Asia Pacific Region and the 35th Annual Meeting of the IADR Korean Division.

The objective of this research study was to compare the effectiveness of annual application of silver diamine fluoride (SDF) solution on arresting root caries in community-dwelling elders living in water fluoridated and non-fluoridated areas. This study was conducted in a water fluoridated area (Hong Kong) and also in a non-fluoridated area (Guangzhou). Healthy community-dwelling elders who had at least 5 teeth with exposed root surfaces and not indicated for extraction were recruited and randomly allocated into one of two groups: Gp1 (placebo control) – annually application of soda water; Gp2 (test) – annual application of a 38% SDF solution. Individual oral hygiene instruction and fluoridated toothpaste was provided to all subjects. The status of dental root surfaces were clinically examined by calibrated examiners at baseline and every 6 months.

A total of 533 elders with 138 root surfaces with active caries lesion were recruited at baseline, 260 elders with 84 active root caries lesions in HK and 273 elders with 54 active root caries lesions in GZ, respectively. After 18 months, 75 (54%) of these lesions were reviewed, 51 and 24 in HK and GZ, respectively. The proportions of active lesions that had become arrested were 32% and 75% in Gp1 and Gp2 in HK (X2 test, P < .05), and 11% and 87% in Gp1 and Gp2 in GZ (X2 test, P < .05), respectively. The difference in caries arrest rates in the SDF groups in HK and in GZ were not statistically significant (X2 test, P > .05).

Based on the 18-month result, the researchers concluded that the annual application of 38% SDF solution can arrest root caries in community-dwelling elders. Furthermore, background water fluoride level does not have a statistically significant influence on the effectiveness of SDF. This clinical trial is still ongoing and longer-term results will be reported later.

The research is supported by the IADR/Colgate Community-based Research Award for Caries Prevention.

On the Scene at the Nobel Biocare Global Symposium

Posted on June 23, 2016

June 23, 2016 - Tony Angelini, president of AEGIS Communications, reports from the first day of the Nobel Biocare Global Symposium. 

 

 

Periodontal Disease May Increase Lung Cancer Risk

Posted on June 23, 2016

Chinese researchers have found that individuals with periodontal disease might be at an increased risk of developing lung cancer. The report, published ahead-of-print in the Journal of Periodontology, found that individuals with periodontal disease have a 1.24-fold increased risk of developing lung cancer.

In the report, titled “Periodontal Disease and Incident Lung Cancer Risk: A Meta-Analysis of Cohort Studies,” the authors assess the findings of five cohort studies that evaluated 321,420 participants. The analysis notes an increased risk even after adjusting for participants’ alcohol consumption and smoking habits, both of which are common risk factors for periodontal disease. Study participants who were drinkers, smokers, and had been diagnosed with diabetes—which is an independent risk factor for both lung cancer and periodontal disease—demonstrated a 1.36-fold increase in lung cancer risk.

The data also indicate that women with periodontal disease are more likely than males to develop lung cancer.  

One of the cohort studies cited in the report suggests that certain oral bacteria may be involved in the development of cancer cells in the lungs, while another indicates successful treatment of periodontal disease may lead to a substantially reduced lung cancer risk. Further research is needed to fully understand the link between lung cancer development and periodontal disease.

“This report can be added to the body of literature that associates periodontal disease with other conditions in the body, including diabetes and heart disease,” says Wayne A. Aldredge, DMD, New Jersey periodontist and president of the American Academy of Periodontology (AAP), which publishes the Journal of Periodontology. “While additional research is needed on the possible links between lung cancer and periodontal disease, we know for sure that taking care of your teeth and gums can reduce periodontal disease risk and possibly the risk of other systemic conditions.”

Periodontal disease affects one of every two Americans age 30 and older and is 2.5 times more prevalent than diabetes. Caused by an inflammatory reaction to a bacterial infection below the gum line, periodontal disease can lead to swelling, irritation, receding gums, and tooth loss if left untreated. The AAP recommends regular flossing, brushing twice a day, and undergoing yearly comprehensive periodontal evaluations for the prevention of periodontal disease, which is treatable and often reversible with proper and timely care from a periodontist.

According to the American Cancer Society, lung cancer is the leading cause of cancer death in men and women. About 158,000 Americans are expected to die from lung cancer this year. More people die of lung cancer than colon, breast, and prostate cancers combined.

Roland Holds Grand Opening for East Coast Imagination Center

Posted on June 23, 2016

Roland DGA’s new Wilmington, Massachusetts-based Roland Imagination Center celebrated its Grand Opening with a reception that included a ribbon-cutting ceremony, guided tours of the 3,500 square-foot facility, demonstrations of the company’s latest wide-format digital printers, and more. Attending the June 16 event were Roland DGA dealers and end users, members of the press, the Wilmington Chamber of Commerce, and even a State Senator. Now open to the public, the Imagination Center will serve as a product display and application venue, as well as a training and sample production site for Roland resellers, customers and prospective customers.

“The Grand Opening was a lively, well-attended event, and we were thrilled to receive such a warm welcome from not only the Chamber of Commerce, but also State Senator Bruce Tarr and other important Massachusetts representatives,” said Rick Scrimger, president of Irvine, California-based Roland DGA Corporation.

In addition to serving as an East Coast training and product demonstration facility, the new Imagination Center features a Roland Creative Center gallery showcasing a wide variety of products made by Roland DG customers and technologies.

 

Roland DGA President Rick Scrimger (center-left) and Imagination Center Manager Scott Burgess (center-right) do the honors in a ribbon-cutting ceremony hosted by the Wilmington Chamber of Commerce for Roland DGA’s new East Coast Imagination Center in Wilmington, Massachusetts.

 

Entrance to the new Roland DGA East Coast Imagination Center, a state-of-the-art 3,500 square-foot facility that will serve as a product display and application venue, as well as a sample production site for Roland resellers, customers and prospective customers.

Roland DGA’s new East Coast Imagination Center includes a Creative Gallery showcasing a wide range of products made by Roland end users and technologies.

For more information on Roland DGA’s new East Coast Imagination Center, or the complete Roland product lineup, visit www.rolanddga.com.

 

Innovation at Nobel Biocare Global Symposium 2016

Posted on June 23, 2016

Nobel Biocare today welcomes dental professionals from around the world to the iconic Waldorf Astoria hotel in New York City, US, for the Nobel Biocare Global Symposium 2016. The program for the sellout event, which runs until June 26, features lectures, hands-on training and master classes from the world’s leading experts in implant dentistry. Under the banner “Where innovation comes to life”, Nobel Biocare is unveiling a number of innovative new products and solutions at the event. Each is designed to help dental professionals treat more patients better and many are so unique they are either patent protected or in the patent process.

Enhancing workflows for shorter time-to-teeth

The Nobel Biocare Global Symposium showcases the role that digital technology plays in increasing the efficiency and accuracy of diagnostics, treatment planning and guided surgery. Attendees are invited to visit a digitally enabled practice exhibit featuring current technology as well as potential future innovations designed to increase integration, collaboration and efficiency. Participants will see how Nobel Biocare’s leading integrated workflow can accelerate, combine or even eliminate treatment steps.

Nobel Biocare is also advancing the restorative workflow in terms of componentry. An important new addition to Nobel Biocare’s assortment of components is the On1 concept.1 This innovative modular solution bridges the gap between the surgical and prosthetic workflows. The On1 Base connects to the implant at surgery and then remains in place throughout the healing process, prosthetic work and then the lifetime of the restoration. This leaves the soft tissue undisturbed without compromising on restorative flexibility, leaving the biological seal it creates in place for optimized healing.

As the On1 Base is seated at implant placement, the concept offers the surgeon peace of mind that only precision-engineered Nobel Biocare components are used with the implant, removing risks associated with ill-fitting third-party abutments. It also eliminates the risk that non-biocompatible, unclean or reused components come into contact with the soft tissue. For a restorative clinician, the On1 Base allows for an improved patient experience, as the discomfort previously associated with the removal of healing abutments can be completely avoided. With two height options available, there is the flexibility to change the On1 Base should the thickness of the soft tissue require it in the short or long term – an option not available with tissue-level implants. As the healing cap of the On1 concept supports an intraoral scanning approach, conventional impression-taking procedures for delivery of the final crown can be eliminated.

Nobel Biocare will also present the evolution of NobelProcera. This includes the launch of the new NobelProcera Crown, the first in a series of options in a new high-translucency multilayered full-contour zirconia material. This new material possesses exceptional properties, combining high strength and durability with excellent esthetics. The multilayered nature of the restorations and the realistic occlusal detail mirror the appearance of a natural tooth and help save time, as the technician need only apply final touches before delivery to the dentist.

It is now easier than ever to obtain precision-engineered NobelProcera restorations. One route is via the new NobelDesign CAD software, which offers dental technicians powerful CAD tools with an intuitive and adaptive interface. Another access point is NobelProcera Scan and Design Services. This option allows NobelProcera restorations to be ordered by simply sending case information to NobelProcera’s advanced industrial production facilities. NobelProcera products are also available to users of the 3Shape Dental System™ via an open-access partnership. All options lead to NobelProcera restorations of outstanding quality, each manufactured for predictable long-term performance.

Advancing edentulous solutions

As the leader in edentulous treatment and the company behind the revolutionary All-on-4® treatment concept, Nobel Biocare is committed to further advancing the standard of care for edentulous patients.

NobelSpeedy, the original and widely documented implant for the All-on-4® treatment concept, is now available in more lengths and diameters for increased surgical flexibility. With new shorter 7 mm, longer 20, 22 and 25 mm implants and a wider 5.0 mm implant variant, this expanded range is designed to further help clinicians utilize a graftless approach and achieve cortical anchorage where bone quality and quantity are limited, allowing more patients to benefit from the proven advantages of the All-on-4® treatment concept.

The new Multi-unit Abutment Plus1 is an enhancement of the Nobel Biocare Multi-unit Abutment. It is designed to significantly reduce the chair time required to perform a denture conversion – a procedure commonly used for the All-on-4® treatment concept. By introducing a snap-fit function between the temporary cylinders and the abutment, screws are no longer required during the try-in process. This means the common practice of removing the temporary cylinders and the denture several times during the conversion process can be done in a few snaps, with no need to tighten and loosen four screws each time. This represents a significant time-saving opportunity for the clinician. It can also dramatically reduce the amount of time the patient has to spend holding their mouth open, removing any worry about the screws potentially dropping out.

Building on 25 years of success with Nobel Biocare’s zygomatic implants, the new NobelZygoma implant launching at the event provides greater surgical and prosthetic flexibility when treating severe maxillary resorption without grafting. This new option for zygomatic implant placement has an unthreaded implant body designed to interface with soft tissue and, depending on the anatomical situation, parts of the implant body can be located outside of the maxillary sinus. A new tapered apex design has been added to support high primary stability for Immediate Function.

Comprehensive regenerative assortment

Under the brand creos, Nobel Biocare offers an outstanding regenerative solutions portfolio, which is now expanded further with creos xenogain, a deproteinized bovine bone mineral matrix for guided bone and guided tissue regeneration procedures. Unique processing methods remove the bovine proteins and lipids.2,3 The natural bone matrix characterized by micro- and interconnected macropore structures is preserved.2,3 Bone substitutes in the creos xenogain range have a slow resorption rate and act as a long-lasting scaffold, maintaining space for bone regeneration.4  To meet a variety of clinical needs and preferences, creos xenogain is available in multiple sizes and application methods.

The new creos xenogain biomaterials build on the success of the non-cross-linked resorbable collagen membrane creos xenoprotect, which is scientifically proven to be the strongest membrane when hydrated5 and offers excellent vascularization behavior and tissue compatibility as well as a prolonged protection of the graft site.6 An extensive range of allogenic creos regenerative solutions is also available.7

Hans Geiselhöringer, President, Nobel Biocare and Dental Imaging, said, “The innovations we are presenting at the Nobel Biocare Global Symposium 2016 have all been created to address the specific needs of today’s dental professionals as they strive to improve care for patients. Informed by studies confirming the possibilities and advantages offered by immediate placement and provisionalization, many of these new products and solutions are so unique that they are either patent protected or in the patent process. They will enable our customers to work with greater efficiency, accuracy and quality to reduce time-to-teeth.

 “From the TiUnite surface, which is now proven over 12 years of follow-up, to new options for our world-leading All-on-4® treatment concept and the very latest in digital workflow development, we are bringing true innovation to life not only for the attendees at the symposium, but for our customers worldwide and, crucially, for the patient.” 

 For more information about the Nobel Biocare Global Symposium 2016, please visit nobelbiocare.com/global-symposium-2016.

Broccoli Sprout Extract May Protect Against Oral Cancer Recurrence

Posted on June 23, 2016

Potent doses of broccoli sprout extract activate a “detoxification” gene and may help prevent cancer recurrence in survivors of head and neck cancer, according to a trial by the University of Pittsburgh Cancer Institute, partner with UPMC CancerCenter, confirming preliminary results presented last year at the American Association for Cancer Research Annual Meeting.

It is the first study demonstrating that the extract protects against oral cancer, with the results of human, animal and laboratory tests reported today in the journal Cancer Prevention Research. This research is funded through Pitt’s Specialized Program of Research Excellence grant in head and neck cancer from the National Cancer Institute.

“With head and neck cancer, we often clear patients of cancer only to see it come back with deadly consequences a few years later,” said lead author Julie Bauman, MD, MPH, codirector of the UPMC Head and Neck Cancer Center of Excellence. “Unfortunately, previous efforts to develop a preventative drug to reduce this risk have been inefficient, intolerable in patients and expensive. That led us to ‘green chemoprevention’—the cost-effective development of treatments based upon whole plants or their extracts.”

Cruciferous vegetables, such as broccoli, cabbage, and garden cress, have a high concentration of the naturally occurring molecular compound sulforaphane, which previously has been shown to protect people against environmental carcinogens.

Bauman and her colleagues treated human head and neck cancer cells in the laboratory with varying doses of sulforaphane and a control, and compared them to normal, healthy cells that line the throat and mouth. The sulforaphane induced both types of cells to increase their levels of a protein that turns on genes that promote detoxification of carcinogens, like those found in cigarettes, and protect cells from cancer.

In a small preclinical trial, 10 healthy volunteers drank or swished fruit juice mixed with broccoli sprout extract for several days. The volunteers had no significant problems tolerating the extract and the lining of their mouths showed that the same protective genetic pathway activated in the laboratory cell tests was activated in their mouths, meaning that the sulforaphane was absorbed and directed to at-risk tissue.

Bauman collaborated with senior author Daniel E. Johnson, PhD, professor of medicine at Pitt and a senior scientist in the UPCI Head and Neck Cancer Program, to see how the extract performed in mice predisposed to head and neck cancer. The mice who received the sulforaphane developed far fewer tumors than their counterparts who did not receive the extract.

The results of the mouse, human, and lab studies have been so successful that Bauman has started a larger clinical trial in volunteers previously cured of head and neck cancer. These participants are taking capsules containing broccoli seed powder, which is more convenient to take regularly than the extract mixed with juice.

“Head and neck cancers account for approximately 3% of all cancers in the US, but that burden is far greater in many developing countries,” said Bauman. “A preventative drug created from whole plants or their extracts may ease the costs of production and distribution, and ultimately have a huge positive impact on mortality and quality of life in people around the world.”

A-dec Partners with Dr. Mark Tholen for Expanded CE Design Classes

Posted on June 22, 2016

NEWBERG, Ore. — June 20, 2016 — A-dec is pleased to announce a new and expanded Continuing Education (CE) program, presented by dental office design leader,Dr. Mark Tholen. This class, titled “Inspiring Success: Expand Your Practice Vision,” will cover topics ranging from space planning and operatory flow, to practitioner health. Participants will gain valuable insight to create an optimal practice design and successfully navigate those common pitfalls in a remodeling and construction project.  

Dr. Tholen, DDS, MBA, is well known in dental design. A best selling author, he is also a respected speaker, and former CEO of one of the country’s leading dental design firms, where he was involved with the design and construction of more than 3,000 offices. His book, “A Guide to Designing the Elegant Dental or Medical Office...The Largest Marketing Tool of Your Career,”  draws upon many of the dental office design principles from his time at T.H.E. Design, Inc. His years of practice and work with equipment and office design enhances his appreciation and knowledge of ergonomics, which he has shared as the Editor of Dental Office Design for Dentistry Today, as well as authoring numerous articles on dental office design and ergonomics.

A-dec’s first “Inspiring Success: Expand Your Practice Vision” class with Dr. Tholen will be offered September 8-9, 2016, in Newberg, Oregon. It is accepted by the ADA, (American Dental Association), the Academy of General Dentistry, and PACE (Program Approved for Continuing Education). Participants earn 12 credits upon completion.

“The look and feel of a dental practice is a great marketing tool, and ensuring that the office is designed for efficiency and ergonomic health is essential,” says Mariah Kraner, A-dec Customer Experience Manager. “This program shows how to accomplish these goals. It will provide practical information and the steps to help participants achieve a more successful practice. A-dec’s goal is to help dentists attain the practice of their dreams.”

For more information about this course, visit us.a-dec.com/Inspiring-Success.

 

AO Announces 2016 Outstanding Students in Implant Dentistry

Posted on June 22, 2016

CHICAGO, June 22, 2016 – The Academy of Osseointegration (AO) has announced the recipients of the 2016 Outstanding Dental Student in Implant Dentistry Award. More than 50 students from dental schools across the country will receive the award, which honors their commitment to the field of implant dentistry.

Each student will receive a free year of AO membership, a complimentary subscription to the International Journal of Oral & Maxillofacial Implants (JOMI),a certificate and $500. Additionally, each will receive complimentary registration for AO’s 32nd Annual Meeting set for March 15-18, 2017, in Orlando, Fla.

“This award is given to support and expand students’ interests, education and research in dental implants,” said Dr. Alan Pollack, AO President. “The commitment these students show to the field of implant dentistry is exemplary. They are truly the future of our organization.”

Recipients of the 2016 Outstanding Dental Student in Implant Dentistry are:

Carter D. Beckham

University of Louisville, School of Dentistry

Vanessa Bikhazi

New York University, College of Dentistry

Jonathan P. Bishop

Tufts University, School of Medicine

Emily K. Boothby

Ohio State University, College of Dentistry

Michael Britting

University of Nevada, Las Vegas School of Dental Medicine

Arielle K. Castine

University of Michigan, School of Dentistry

Derek Chenet

Columbia University, College of Dental Medicine

Isaac Chinitz

Stony Brook University, School of Dental Medicine

Holly M. Clark

Indiana University, School of Dentistry

Andrew Correces

Loma Linda University, School of Dentistry

Michael K. Cvelich

University of North Carolina at Chapel Hill School of Dentistry

Rushi P. Dave

University of Pittsburg, School of Dental Medicine

Steven J. Van De Graaff

Creighton University, School of Dentistry

Navjot S. Dhillon

University at Buffalo, School of Dental Medicine

Colin P. Don

University of Southern California, Herman Ostrow School of Dentistry

Brittany E. Fignar

Case Western Reserve University School of Dental Medicine

Mikala Gaffke

Marquette University, School of Dentistry

Napoleon Gaither

Meharry Medical College, School of Dentistry

Stephanie R. Ganter

Texas A & M University, Baylor College of Dentistry

Neha Grewal

University of Connecticut School of Dental Medicine

Pavel Y. Ivashchuk

University of Maryland, School of Dentistry

Erica E. Jasa

University of Nebraska Medical Center College of Dentistry

Jonathan J. Jelmini

University of California, San Francisco, School of Dentistry

Kevin C. Kaiser

University of Missouri, Kansas City School of Dentistry

Philip Kaplan

Howard University College of Dentistry

Garrett F. Kever

Louisiana State University, School of Dentistry

Grant T. King

University of Tennessee Health Science Center, College of Dentistry

Kasey M. Kirchner

Southern Illinois University, School of Dental Medicine

George K. Koch, III

Harvard School of Dental Medicine

Deanna S. Lee

University of the Pacific, Arthur A. Dugoni School of Dentistry

Ellen B. Lee

University of Mississippi, School of Dentistry

Austin L. Lyman

Temple University, Kornberg School of Dentistry

Cory McMahan

West Virginia University, School of Dentistry

Brin L. MacMillan

University of Detroit Mercy, School of Dentistry

Katiuska Mcintosh-Falcon

University of Puerto Rico – School of Dental Medicine, Medical Sciences Campus

Edmund P. Monsef

A.T. Still University, Arizona School of Dentistry & Oral Health

Alexander M. Munaretto

University of Illinois at Chicago, School of Dentistry

Robert H. Painter, IV

Medical University of South Carolina, James B. Edwards College of Dental Medicine

Ed G. Pantzlaff

University of Iowa, College of Dentistry and Dental Clinics

Joel Pinter

Rutgers University, School of Dental Medicine

Michelle J. Peters

Virginia Commonwealth University, School of Dentistry

Steven C. Petritz

University of California, Los Angeles, School of Dentistry

Ashwin Ravisankar

University of Kentucky, College of Dentistry

Jennifer Ryan

Augusta University, The Dental College of Georgia

Reza H. Shoushtari

University of Pennsylvania, School of Dental Medicine

Caroline A. Olsen Smith

University of Washington, School of Dentistry

Justin R. Smith

University of Florida, College of Dentistry - Gainesville

Alexander Sonesson

Oregon Health & Sciences University, School of Dentistry

Jason M. Tartagni

Nova Southeastern University, College of Dental Medicine

Kyle P. Trobough

University of Texas Health Sciences Center at San Antonio, Dental School

Justin M. Young

University of Oklahoma, College of Dentistry

Lianna G. Zabanal

University of Texas, School of Dentistry at Houston

Li Zhong

Boston University, Henry Goldman School of Dental Medicine

Rates of Nonmedical Prescription Opioid Use and Opioid Use Disorder Double in 10 Years

Posted on June 22, 2016

Nonmedical use of prescription opioids more than doubled among adults in the United States from 2001-2002 to 2012-2013, based on a study from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health. Nearly 10 million Americans, or 4.1% of the adult population, used opioid medications in 2012-2013 a class of drugs that includes OxyContin and Vicodin, without a prescription or not as prescribed (in greater amounts, more often, or longer than prescribed) in the past year. This is up from 1.8% of the adult population in 2001-2002.

More than 11% of Americans report nonmedical use of prescription opioids at some point in their lives, a considerable increase from 4.7% 10 years prior.

The number of people who meet the criteria for prescription opioid addiction has substantially increased during this timeframe as well, with 2.1 million adults (0.9% of the US adult population) reporting symptoms of “nonmedical prescription opioid use disorder (NMPOUD),” according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).  

“The increasing misuse of prescription opioid pain relievers poses a myriad of serious public health consequences,” said Nora D. Volkow, MD, director of the National Institute on Drug Abuse (NIDA), which contributed funding for the study. “These include increases in opioid use disorders and related fatalities from overdoses, as well as the rising incidence of newborns who experience neonatal abstinence syndrome. In some instances, prescription opioid misuse can progress to intravenous heroin use with consequent increases in risk for HIV, hepatitis C, and other infections among individuals sharing needles.”

Scientists analyzed data from NIAAA’s National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), ongoing research that examines alcohol and drug use disorders among the US population, as well as associated mental health conditions.

The study appears online today in the Journal of Clinical Psychiatry.

Prescription opioid misuse is an urgent public health problem, with drug poisoning deaths involving opioid analgesics, which includes both prescription and illicit opioids, quadrupling between 1999 and 2014, according to the Centers for Disease Control and Prevention. Emergency department visits increased by 153% from 2004 to 2011, based on data from the Substance Abuse and Mental Health Services Administration’s Drug Abuse Warning Network.

“Given the dramatic increase in nonmedical use of prescription opioids, it is important that clinicians and patients also recognize the potent interaction of opioids with alcohol and other sedative-hypnotic drugs – an interaction that can be lethal,” said NIAAA Director George F. Koob, PhD.  

People who develop alcohol use disorder at some point in their lives are nearly twice as likely to also develop opioid use disorder, based on NESARC-III data.

Similar to other substance use disorders, prescription opioid use disorder includes symptoms such as taking the drug in larger amounts or over a longer period than was intended, the persistent desire to cut down or control use/unsuccessful efforts to do so, failure to fulfill major role obligations at work, school or home as a result of prescription opioid use, and symptoms of tolerance and/or withdrawal.

Rates of nonmedical prescription opioid use were greatest among men, those with annual incomes less than $70,000, those previously married, and with a high school-level education or less. Use was greater among whites and Native Americans and those living in the Midwest and West.

Study results also show that few people misusing prescription opioids receive treatment. Based on NESARC-III data, only about 5% of people misusing prescription opioids in the past year and 17% of those with prescription opioid use disorder ever receive help. Evidence-based treatment options for addiction to prescription opioids include medications and behavioral counseling approaches.

“The national data from NESARC-III substantially advances what we know about prevalence, co-occurring disorders and treatment rates,” said senior author Bridget Grant, PhD, PhD, chief of the NIAAA Laboratory of Epidemiology and Biometry. “Prior to this analysis, there was a lack of current epidemiologic data on nonmedical prescription opioid use and prescription opioid use disorder using DSM-5 criteria.”

Based on the 2012-2013 NESARC-III data, 2.1% of US adults (4.8 million) have ever had prescription opioid use disorder in their lifetime and 0.9% had this disorder in the past year, according to DSM-5 criteria. This compares to 1.4% lifetime and 0.4% past year rates in 2001-2002, with slightly different criteria under the DSM-IV. Rates for 2012-2013 NESARC-III using DSM-IV criteria were 2.9% and 0.8%, respectively.

Overall, the study found that nonmedical prescription opioid use among US adults has increased by 161% from 2001-2002 to 2012-2013 while prescription opioid use disorder has increased by 125%. The authors suggest that this may be due in part to increase in opioid prescribing and dosage, lessened perception of risk because of its legality, and lack of understanding of addictive potential.

The researchers found that nonmedical prescription opioid use and prescription opioid use disorder are linked to other drug use disorders, and a variety of mental health disorders including posttraumatic stress disorder, and borderline, schizotypal, and antisocial personality disorder. Persistent depression and major depressive disorder are linked to nonmedical prescription opioid use, while bipolar I disorder is linked to prescription opioid use disorder.

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