E. Steven Moriconi, D.M.D., has been Chief of the Dental Division at Abington Hospital and Program Director for the hospital’s general practice dental residency since 1987. He also has his own thriving oral surgery private practice in Jenkintown. In other words, he has long been passionate about dentistry.
Taking on the Opioid Crisis
Dr. E. Steven Moriconi has been traveling across Pennsylvania with a clear mission: educating his fellow dental professionals to “say no” to prescribing potentially addictive painkillers.
In recent years, his profession has led him to another passion: educating other dental professionals about the dangers of prescribing narcotic painkillers to patients as a way to tackle the opioid epidemic. From his perspective, it’s hard not to pay attention to the crisis considering the toll opioids have taken on American families, including the increasing number of deaths attributed to substance use disorder.
“Pennsylvania has the dubious honor of being the fourth highest state in the country in terms of severity of the opioid crisis,” he explains. “Our state has had 36 deaths per 100,000 people as of 2016, which launched us into the top five. The disease of substance use disorder has become a serious epidemic, killing over 4,600 Pennsylvanians in 2016.”
As a dentist and oral surgeon, Dr. Moriconi has prescribed narcotics to post-procedural patients throughout his career; after all, this is exactly what he and the majority of other dentists were trained to do. But when he started researching the epidemic in 2012, he found out dentists were prescribing approximately 12 percent of the opioids in the United States—more than 100 million pills per year, he says, approximately half of which typically go unused.
“As of 2012, dentists were possibly leaving about 50 million unused opioids in the environment, and that contributed to opioid use disorder simply because there were so many pills out there, including many in medicine cabinets,” he adds. “Where is the only place in your house that teenagers can go and lock the door? The bathroom! That hit me pretty hard.
“I noticed that many of my patients when I call the day after their surgery would tell me they took one narcotic pill and felt sick, or they took none because they felt they didn’t need it,” he continues. “Rarely did anybody ever take all of the prescribed pills, even if I only prescribed five or six. Two years ago I stopped prescribing them altogether.”
Now he is on a mission to educate other dental professionals in the state of Pennsylvania on why and how to stop prescribing narcotic painkillers to patients. Through a partnership with the Pennsylvania Dental Association, he is traveling across the state to spread awareness, talk about the dangers of prescription pills, and recommend alternatives to offer patients after they undergo various dental procedures.
“Research shows you can give patients a combination of Tylenol and Advil together and that was just as effective in alleviating pain as an opioid—in fact, better,” he says. “I’ve gotten almost completely away from opioids [in my practice], and because I started on this path, I’m trying to educate fellow surgeons and other dentists, students in dental schools, and residents in my training program at Abington. Many of my residents come out of dental schools and would think to prescribe opioids for everything—root canal, a pulled tooth—but that’s not necessary.”
During his lectures, Dr. Moriconi shows videos of people in the midst of recovering from drug addiction, some of whom have lost their teeth or suffered from gum disease. More often than not, he says, dental professionals are shocked by what they see.
“Thankfully, there’s legislation in Pennsylvania that should help,” he says, adding that there are many initiatives at the state and local levels to improve access to care for those who are addicted. “Starting in 2019, all dentists in the state who are licensed must take a two-hour course/lecture on substance use disorder, including information such as what defines the disease of addiction, the adverse effects of opioids in society, as well as where we stand statistically in the state of Pennsylvania.”
The entire process has been an eye-opening experience for Dr. Moriconi, as well as for the professionals he’s been educating. While he believes his efforts have helped to significantly “move the ball” in a positive direction, he admits there is still a long way to go.
“We’re already seeing in my audiences very few dentists admitting to prescribing opioids anymore,” he says. “As of 2016, 6 percent of dentists nationwide prescribed opioids, which is still a lot of pills. Until we get close to zero, I don’t think our work is done.”
E. Steven Moriconi, D.M.D.
609 Harper Avenue
Photography by Jody Robinson