Opioid Prescribing Trends by Croatian Dentists - Is there a Reason for Concern?

Prescription opioid abuse, associated with numerous opioids, is a well-established public health problem in developed countries such as the UK, US and Australia. Opioids have a limited role in general dental practice; hence the aim of this study was to assess prescribing rates of opioids in dentistry from 2013 to 2023 in Croatia.

Data on opioid prescribing practices for this study were provided by the Croatian Health Insurance Fund. The analysis included the number of prescriptions, cost, and the number of packages prescribed.

Over the 11 years, dentists in Croatia have prescribed a total of 9132 opioid prescriptions, representing annually on average 1,1% of all analgesic prescriptions, and 0,2% of all dental prescriptions. The number of opioid prescriptions per 1,000 dental patients was on average 0, 19. Tramadol/paracetamol and tramadol were the most prescribed opioids, with average annual number of prescriptions amounting to 622, 7 (64% of opioids prescriptions) and 114, 5 (1, 1% of analgesic prescriptions), respectively. Trends in opioid prescription varied, especially during pandemic years (2020-2022), when tramadol rates decreased while fixed combination medications tramadol/paracetamol and tramadol/dexketoprofen increased. But an overall increasing trend was observed during that period.

Dentists in Croatia are restrictive and conservative in prescribing opioids, and there is no need for intervention, but because of increasing trends, observing the prescribing pattern in the future is highly recommended.