Foundations in Continuing Education

Substance Abuse and Chemical Dependency

Chapter Eight - Impaired Oral Health Team Members

Chapter 1: Background Terminology

Chapter 2: Epidemiology

Chapter 3: Pathophysiology of Addiction

Chapter 4: Classification and Characteristics of Psychoactive Substances

Chapter 5: Treatment

Chapter 6: Identification of the Abusing Patient

Chapter 7: Implications for Dental Treatment

Chapter 8: Impaired Oral Health Team Members

Chapter 9: Conclusion

Appendices

Post Examination

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Dental professionals are at increased risk for substance abuse.

Precipitating factors include:

  • Genetics
  • Family of origin issues
  • Substance abuse prior to dental education
  • High levels of stress: dental and dental hygiene education
  • Dental practice
  • Isolated practice settings
  • Perceived limitations of reward in providing care to others
  • Economic factors
  • Access and availability of substances
  • Unrealistic expectations of performance by self and others
  • Belief in medication as a solution to problems
  • Demand for quick results
  • Focus on the needs of others

Members of the oral health team suffer from chemical dependency. Incident rates vary. Fears of losing ones license and damage to ones professional reputation keep dental professionals from seeking treatment. Clues that you may be working with an impaired person include, withdrawal from daily activities, decline in personal hygiene and appearance, disruption of appointment schedule, unexcused absences from work, in the office after hours, and excessive and/or unapproved ordering of drugs.

The dentist is responsible for his/her DEA number and privileges. To prevent employees from obtaining unauthorized prescriptions for hydrocodone and other medications, the dentist should write and/or call in all narcotic prescriptions and monitor personal prescription activity through the DEA.

Be aware of nitrous oxide abuse by the oral health team.

In some states it is the second drug of choice following alcohol abuse.

  1. Monitor purchase frequency and amount
  2. Be aware of dentist or staff members in the office after hours, and
  3. Confine tanks to an area that can be secured and limit number of personnel who have keys.

Continue on to Chapter 9: Conclusion