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It has been about 30 years since the first wave of the opioid epidemic laid the groundwork for the spiraling pattern of devastation that has plagued the American patient population. As the infamous public health crisis has worsened, the term “opioid” has come to take on a meaning far beyond its uncolored, scientific definition of a class of pain-relieving drugs. The life-threatening risks of opioid use have become an overwhelming part of the definition itself, indicative of the extent to which the crisis has impacted the understanding and attitude towards prescription pain management.
Of course, there is a positive side to this alarming progression. It has generated necessary awareness and demand for solutions, leading to numerous efforts to control the epidemic and preserve patient safety, so that patients are still able to benefit from pain-relieving drugs without being put at risk of misuse and addiction.
However, these initiatives can only be successful with proper understanding and engagement from the provider side. Now more than ever, patient’s need their doctors to be actively involved in their opioid management. The patient-provider relationship is key to developing safe and effective prescription programs, and is the point at which efforts should be targeted to bring the crisis under control.
Unfortunately, as the opioid crisis has escalated, some primary care physicians are becoming less comfortable with managing pain patients. Aware of the challenges, risks, and complications associated with opioid prescribing, some physicians are simply choosing to avoid chronic pain patients all together. A recent report by Quest Diagnostics titled Drug Misuse in America 2019: Physicians Perspectives and Diagnostics Insights on the Evolving Drug Crisis, shows that 81% of 500 sampled primary care physicians are hesitant to accept new patients who have been prescribed pain meds, while 83% claim that the ongoing opioid crisis has made it increasingly difficult to treat patients suffering from chronic pain. Another study reported that 25% of physicians are not confident in getting patients off of addictive drugs. Along with finding it difficult to provide personalized care while also complying with generalized opioid prescribing guidelines, physicians fear consequences such as legal sanctions and low patient satisfaction scores, making them less eager to deal with chronic pain patients.
This is not to say that physicians are unwilling to care for their patients. The unfortunate truth is that circumstances have made it so that there are considerable risks and liabilities to providing care to patients with chronic pain, and some physicians do not have adequate education and tools to provide effective care. While wide scale guidelines and regulations are helpful in avoiding overprescribing, they do not tackle the issue of helping physicians gain comfort and confidence in delivering opioid-related care, highlighting a major area of concern that must be addressed. There is an urgent need for initiatives such as patient monitoring tools and educational resources to help physicians better care for their pain patients, allowing them to gain control over the opioid prescription process and feel assured about their ability to keep patients safe and healthy.