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Cannabis Supporting Your Practice

Special Series, Part Three: Effective Alternative Treatments to Opioids

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Dr. Jose Lança is an M.D., PhD., and Assistant Professor at the Faculty of Dentistry, Department of Pharmacology and Toxicology at the University of Toronto.

In this third and final interview in our series, Dr. Lança delivers important insights on treating patients within the current opioid crisis and provides evidence-based, alternative treatments for pain management.

Effective alternatives to opioids and other pain management resources in dentistry

  • Opioid use, misuse, and abuse.
  • Discussing the risks and shared responsibility for the opioid crisis among institutions, pharma companies, and prescribing healthcare professionals.
  • Statistical review: which healthcare professionals prescribe the most opioids to patients?
  • Alternative pain management treatment: options, efficacy, and safety.


Special Series Part One, Impairment and Intoxication: Cannabis and Dental Management 

Special Series Part Two, Drug Interactions: Cannabis and Analgesics, Sympathomimetics, Liver Enzyme Inhibitors

Watch Dr. Lança’s presentation, Opioids: The Good, The Bad, and The Ugly

Read/download the transcript of the conversation (PDF)

Full Conversation (14.33″)

We always want to hear your thoughts and questions.

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Until next time!

CDA Oasis Team

1 Comment

  1. Bruce Burgess March 15, 2019

    Thank you for your presentation.

    I have a couple of questions. Firstly, the dose response curve for NSAIDS + ASA are given but they don’t compare it with opioids. That leaves the obvious question of how do these relate?

    The second question I have relates to the definition of efficacy. The presenter compares UK and NA methods of pain control, but this ignores cultural issues around what adequate pain control is. We are causing acute pain, it will end and the patient will go on to forget the post-operative course. The safest thing would be to provide no analgesia; however, we are expected to act in a humane way and alleviate our patient’s pain. I suspect this is greatly influenced by cultural expectations. The presenter says that British patients have the same pain that North American patients have, and that is probably true; however, I doubt that they have the same expectations of treatment. I don’t think that can be casually ignored.

    The comparison between ER physicians, Family Medicine specialists and dentists is a red herring. We all treat pain but that is about where the similarity stops. Dentists are causing acute pain in surgery. We generally know our patients, their medical, social and dental histories. We are more equipped to treat our patient’s pain in a holistic way than an ER doctor who is mostly concerned about whether the patient is going to die in their ER and probably has little to no knowledge of their history. Comparisons like these detract from the seriousness of the presentation.

    I do prescribe opioids from time to time as they are effective and relatively safe. I don’t hand them out without thought or insight. The implication of all the anti-opioid talk these days is that any opioid use is bad and creates a social blight. Opioids are neither good nor bad. They are a tool. Used in the right hands with care and forethought they are one of the great gifts of medical science. Don’t throw out the baby with the bathwater.

    Not everyone who has had their pain treated with opioids has gone on to overdose. I suspect the current crisis we are enduring has more to do with social and mental health issues and the introduction of fentanyl-like drugs to the illicit drug supply than the prescribing practices of physicians and dentists.

    My personal opinion is that I am getting a little tired of our professional organizations constantly telling us we are creating a problem that we actually have no control over.

    Reply

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