Opioid Prescription Reduction after Dentoalveolar Surgery-A Success Story in the Recruit Training Environment

Given the public health toll exacted by the Opioid Crisis, it is important for providers in all disciplines to examine their opioid prescribing patterns to see where opioid reduction strategies can be effectively employed. Limiting the impact of the Opioid Crisis on active duty service members is a critical component of maintaining a ready fighting force. One avenue for reducing the potential for opioid diversion and abuse is developing and implementing non-opioid postsurgical pain management strategies that both provide adequate pain relief and also ensure an expedient return to full duty. Dentoalveolar surgeries performed by oral and maxillofacial surgeons to maintain operational dental readiness are a good example of common procedures necessitating post-procedural pain medications and convalescent days impacting availability for full duty. The providers at US Navy Recruit Training Command's oral surgery clinic undertook a process improvement initiative to reduce opioid prescriptions after dentoalveolar surgery. This change was accompanied by a concerted education effort aimed at both providers and patients on the benefits of avoiding opioids as well as the importance of strict adherence to a standardized medication dosing regimen for efficacious non-opioid pain control consisting of maximum doses of ibuprofen and acetaminophen taken every six hours. No increase in convalescent time off and no increase in postoperative visits related to pain control were noted. In our experience, eliminating routine post-procedure opioids for dentoalveolar surgery was a viable strategy for reducing the potential for opioid diversion and abuse among our patients with no negative impact on the operational and training tempo of the associated command.