Opioids are devastating tens of thousands of American lives. More than 42,200 overdose-related deaths were attributed to opioids in 2016 and about 40 percent of those deaths involved a prescription. The issue has been declared a public health emergency in the U.S. and much of the blame has been aimed at physicians who have prescribed these drugs to patients at an increasing rate in recent decades.
But how do doctors and pharmacists feel about America’s growing epidemic? We surveyed 185 medical professionals on their perceptions of opioid prescriptions, media coverage of the opioid crisis, and how it affects their ability to treat patients.
Read on to see how the humans standing in hospital rooms, behind pharmacy counters, and at the beginning of legal prescription opioid supply chains perceive a national issue that’s affecting more lives every day.
Professional Opinions
Opioid prescriptions among health professionals have risen in popularity in the last few decades, with noticeable growth starting in the 1990s. Given the recent rise of these drugs as a way of treating pain, it’s important to understand when doctors and other medical professionals believe they should use opioids. It’s also important to know if they see any better alternatives in the era of America’s opioid crisis.
We asked nurses, pharmacists, doctors, and other medical professionals about the perceived risks of opioids. Interestingly, doctors believed there were health risks to opioid side effects, but only 10.3 percent rated the risk as “extremely high,” compared to 17.3 percent of nurses and 17.1 percent of pharmacists. However, the majority of doctors surveyed believe there was a significant risk in opioid use: 28.2 percent of doctors rated the risk as “very high” and 38.5 percent as “somewhat high.” Only 15.4 percent of doctors believed the risks were “neither high nor low.”
We also asked medical professionals about the effectiveness of opioid use in pain treatment and whether there were better alternatives. A key takeaway from our study is that medical professionals perceived opioids to be more helpful in treating acute pain than chronic pain. Acute pain is defined as “severe and sudden in onset,” whereas chronic pain is a “long-developing syndrome.”
However, perceived effectiveness does not necessarily make opioids the only good option. Nearly 54 percent of doctors disagreed with the statement, “There are no good opioid alternatives on the market for pain treatment.” Over 56 percent of pharmacists and 36.5 percent of nurses also disagreed with such a statement.
Side Effect: Highly Addictive
It appears most medical professionals are aware of the risks of opioid use and viable alternatives. But are they encountering the opioid crisis in their daily lives – and if so, how do they feel about it?
We surveyed medical professionals about their contact with opioid addicts or someone that may be developing an opioid addiction. Most medical professionals suspected they had given opioids to an addict and a majority of doctors believed one of their patients had developed a dependency on opioids.
Almost 72 percent of doctors suspected they’d prescribed opioids to an addict, compared to 70.7 percent of pharmacists and 53.8 percent of nurses. Meanwhile, a little more than half of the medical professionals stated they knew or suspected that at least one of their patients had developed an opioid dependency. While it’s unlikely that a medical professional intends to negatively impact a patient’s life by introducing opioids, our results indicate that it is indeed happening.
This finding has significant policy implications, because solving the opioid crisis may require more actors than just medical professionals. As it stands, medical professionals were relatively split on whether current U.S. regulations worked to decrease opioid prescriptions. Only about half of doctors believed these regulations were helpful, compared to 61 percent of pharmacists and 46.2 percent of nurses.
Refill, Please?
Prescription opioids are potent and prolonged use of them increases the risk of addiction and overdose. Therefore, it’s crucial to understand how pharmacists and other medical professionals perceive prescription refills for these drugs. Are they ever suspicious of refill requests – and are they ever refusing them?
It turns out that a large proportion of medical professionals are. Seventy-eight percent of pharmacists had doubted a patient requesting opioids sincerely needed them. Meanwhile, medical professionals who were capable of prescribing opioids did sometimes deny refills: 90 percent of those surveyed had done so, while 70 percent said they were asked by a patient for a greater refill than originally prescribed.
But why do medical professionals deny refills? The No. 1 reason was that prescribers felt opioids were “no longer necessary” for treatment. Prescribers also felt there were good alternatives available or denied refills because they were suspicious of opioid addiction. Some simply denied refills because they felt the additional assessment was needed first.
Media Influences
America’s opioid epidemic has garnered substantial media attention in recent years, producing a wide range of news reports on big pharmacies, physician practices, and the illegal prescription drug trade.
But opioids are such a sensitive and complicated issue in the U.S. that journalists have organized public discussions on how to best cover the issue, while academics have conducted literature reviews on the discourse surrounding opioids.
We asked physicians how they felt about the widespread media attention on opioids. It turns out, media had a significant impact on them: 59 percent of doctors said media attention on opioids affected their ability to perform their medical duties. At the same time, 52.5 percent of prescribers said they felt “villainized” by the media.
Despite their grievances with reporters or news organizations, our data also suggest media coverage impacts medical professionals’ behavior – perhaps for the better. About 40 percent of those surveyed said media attention on the opioid crisis influenced them to prescribe opioids less frequently, while 32.5 percent offered patients alternatives to opioids. Thirty percent stated they now checked to see if their patient was susceptible to opioid abuse or conducted research before prescribing opioids.
Sentiments During the Crisis
The opioid crisis continues to be a hot-button topic with the American public, with an estimated 115 people dying from opioid overdoses every day in the U.S. Much of the blame has been directed toward doctors. In opioid-afflicted New York, for example, about 53 percent of residents polled believed physicians were “very responsible” for the crisis.
But where do medical professionals direct the blame – and are they regretting opioids they may have prescribed in the past? Our data suggest most medical professionals felt guilty about prescribing opioids in the context of America’s current epidemic.
Over 43 percent of doctors felt guilty prescribing opioids, compared to 47.4 percent of pharmacists and 36.8 percent of nurses. However, their reasons for feeling guilt varied.
A sizeable portion of opioid prescribers surveyed felt they “didn’t explain health risks well enough” to patients.
This has significant implications for policy and potential solutions since it points out a possible gap in knowledge for recipients of opioid prescriptions.
Over 37 percent of prescribers also stated they felt guilty because there were alternative treatments available. Meanwhile, many medical professionals reported guilt for being too free with opioid prescriptions.
In other words, many medical professionals admit feelings of regret, guilt, or mistakes in how they have dealt with opioids.
Conclusion
Our study gives key insights into how medical professionals are responding to America’s devastating opioid crisis. Not only does our data show medical professionals regularly encounter the opioid epidemic in their practice, but also they’ve doubted a patient’s need for them. Additionally, medical professionals are aware of media coverage of the opioid crisis and the perceptions the public may have of them – in some cases, they feel “villainized” by news reports. To a significant portion of doctors surveyed, this media attention can hinder their ability to do their job. At the same time, many doctors grapple with feelings of regret for over-prescribing opioids in the past.
Join us in decoding addiction, health, and how families can best recover from the opioid epidemic. For more information, please visit the Delphi Health Group website. We are a strong, committed network of drug and alcohol addiction treatment facilities ready to aid you or someone you know.
Methodology
We collected 185 responses from medical professionals. Thirty-nine respondents were doctors, 41 were pharmacists, and 105 were other medical professionals. The term “other medical professionals” includes chiropractors, physical therapists, certified nursing assistants (CNA), licensed practical nurses (LPN), registered nurses (RN), physician assistants (PA), advanced practice registered nurses (APRN), and nurse practitioners (NP). Participants’ ages ranged from 22 to 78 with an average age of 38.6 and a standard deviation of 14.3. 35.1 percent of respondents identified as female, and 64.9 percent identified as male.
The data we are presenting rely on self-reporting. There may be response bias among respondents. Other issues can include selective memory, attribution, and exaggeration.
