The results of a new poll indicating 99 percent of physicians are prescribing opioid painkillers for longer than the three-day period recommended by the Centers for Disease Control and Prevention (CDC) suggests doctors need more education and training, according to an announcement from the National Safety Council.
The non-profit organization surveyed 201 family medicine and internal medicine physicians in early March and found 23 percent said they prescribe at least a month's worth of the addictive opioid medications, when evidence shows that 30-day use of the drugs can cause changes in a patient's brain.
"Opioids do not kill pain. They kill people," Donald Teater, M.D., the council's medical advisor said in the announcement about the poll results. "Doctors are well-intentioned and want to help their patients, but these findings are further proof that we need more education and training if we want to treat pain most effectively."
The poll follows recent action by two federal agencies to mitigate the country's opioid abuse epidemic. The CDC issued guidelines earlier this month advising primary care clinicians to prescribe treatments other than opioids for chronic pain outside of active cancer treatment, palliative care and end-of-life care. The CDC advised when opioids are prescribed for short-term pain, physicians limit the prescription to three days. The Food and Drug Administration last week announced it would place "black box" warning labels on prescription opioids to increase patients' and doctors' awareness of the risks associated with the drugs.
The National Safety Council poll shows physicians have some misconceptions about use of opioid painkillers. Results show:
- Nearly 75 percent of doctors incorrectly believe morphine and oxycodone are the most effective way to treat pain, when research shows over-the-counter pain relievers offer the best relief for acute pain
- Almost all doctors (99 percent) have seen a pill-seeking patient or evidence of opioid abuse, but only 38 percent usually refer the patient to treatment
- Sixty-seven percent of doctors are, in part, basing their prescribing decisions on patient expectations
- While 84 percent of doctors screen for prior opioid abuse, only 32 percent screen for a family history of addiction, which is a strong indicator of potential abuse
- Seventy-one percent prescribe opioids for chronic back pain and 55 percent of dental pain, which is not appropriate in most cases
One doctor, however, pointed out the relatively small number of physicians surveyed in the poll. Deborah Clements, M.D., chair of family and community medicine at Northwestern Medicine, told the Chicago Tribune, the poll was not necessarily representative of the more than 200,000 primary care doctors in the U.S. Doctors are sometimes left with little choice but to prescribe medications to treat patients' pain as insurance companies often won't pay for other interventions such as acupuncture or message therapy, she said.