Practices, Perceptions, and Concerns of Primary Care Physicians About Opioid Dependence Associated with the Treatment of Chronic Pain

ABSTRACT

When prescribing opioids to treat chronic pain, physicians face the dilemma of balancing effective pain management while avoiding iatrogenic opioid addiction. Through mailed surveys, the current study assessed concerns, perceptions, and practices of primary care physicians related to this dilemma. Of the 35 (43%) physicians that replied, 32 (91.4%) reported to prescribe opioids for pain. Twenty-six (81.3%) physicians mentioned that “legitimate pain” was the main reason why most patients who are opioid dependent begin using opioids. Most physicians (71.5%) rated their knowledge/comfort of treatment/management of opioid dependence as being low. Although these physicians believed training is essential to learning about the risks involved with chronic pain and opioid dependence, many of these physicians evaluated their own medical training in these areas as unsatisfactory. Training programs may better equip primary care physicians when addressing the treatment of chronic pain and addiction to opioids.

KEYWORDS:

• Addiction
• chronic pain
• primary care
• opioids

Acknowledgments

This study was supported, in part, by a grant (K23 AA 015616) from the National Institute on Alcohol Abuse and Alcoholism (R.D.B., L.A.), by a scholarship from Center for Human Development (A.M.N.), by a grant from the University at Buffalo Family Medicine Endowment Fund (C.E.K.), and by grant D56HP10318 from the Health Resource Services Administration (J.V.). The authors are grateful for the help of Andy Danzo for his assistance with the preparation of the manuscript.