Opioid Prescribing Patterns of Oral and Maxillofacial Surgeons: A Nationwide Survey

Objectives: Objective of present study is to identify patterns of opioid prescriptions by Oral and Maxillofacial Surgeons (OMFS) following rescheduling of hydrocodone containing products in year 2014.
Methods: 10 questionnaire survey tool was sent electronically to 6,132 OMFS across USA. Chi-square and Fischer-Exact tests were used to examine factors associated with prescription patterns of OMFS.
Results: A total of 1137 OMFS responded to the survey (response rate is 18.5%). 95% responded that they prescribed an opiate for patients who have had one or more impacted third molars removed. Hydrocodone containing products were the most often prescribed (71%). After rescheduling of hydrocodone containing products in 2014, 13.9% used 5 mg dose – 10 tablets (compared to 8.9% before rescheduling). After rescheduling, 20.4% used 5 mg dose – 15 tablets (compared to 17.6% before rescheduling). After rescheduling, 24.9% used 5 mg dose – 20 tables (compared to 33.9% before rescheduling). 92.8% mentioned that they did not change to a more potent drug (hydrocodone to oxycodone containing product) after rescheduling in 2014. 9.6% mentioned that they noticed an increase in post-operative visits requesting refills for hydrocodone containing products after rescheduling. 41.8% mentioned that they noticed less phone calls requesting authorization for refills after rescheduling. 59.8% mentioned that they are more likely to call in a different pain medication after rescheduling. 5.6% mentioned that their prescription patterns vary by practice location. Following a change to a more potent drug after rescheduling, there was a significant reduction in phone calls requesting refill authorizations (64.4% versus 40%, p<0.0001). There was no association between change to a more potent drug and increase in post-operative visits requesting refills and between prescription patterns and patient travel distance to office/number of offices/ or availability of satellite offices.
Conclusions: Rescheduling of hydrocodone containing products appears to influence certain aspects of prescription patterns of OMFS.