Some doctors struggle to strike balance between curbing opioid prescriptions, caring for pain patients

Prescription and pills
Some doctors may struggle with providing pain patients the care they need while also cutting opioid prescriptions. Image: Getty/Gti337

Providers looking to curb the opioid epidemic should provide training to physicians to prevent overprescribing and be clear with patients about the risk—but that's no easy task.

Marc Siegel, M.D., a professor of medicine at NYU Langone Medical Center, wrote in a column for The Wall Street Journal that primary care physicians issue about half of all opioid prescriptions, but many don’t have the training in pain management that they need, which may lead them to jump the gun on prescribing powerful painkillers.


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Physicians should learn the difference between “helping and hurting” patients when it comes to pain management, he said.

Timothy Gammons, M.D., the founder of Detroit-based Gammons Medical, echoed the sentiment in a column for The Detroit News. In addition to a lack of training, for some physicians the financial incentives to reduce opioid prescriptions may not be there, he added.

“Unfortunately, many physicians treating addiction lack the interest in learning how to do it properly,” Gammons wrote. “To learn and implement current standards of care requires time and money and the willingness to provide appropriate care for patients. For some, complying with state requirements to obtain authorizations for prescription medicine or other services is viewed as a nuisance that impedes quick profits.”

RELATED: Doc reduce opioid prescriptions, but pain patients still suffer

Overprescribing of opioids is a main contributor to the opioid epidemic. A survey of doctors conducted last year found that more than half believe physicians that handle narcotics should undergo additional training. The opioid epidemic is also a key issue for the Centers for Medicare & Medicaid Services, and the Centers for Disease Control and Prevention has issued guidelines.

But some docs urge caution in simply slashing opioid prescriptions. In a column for The Hill, Stefan G. Kertesz, M.D., an internal and addiction medicine physician and faculty member at the University of Alabama at Birmingham School of Medicine, said “clumsy” opioid guidelines cause significant harm to pain patients, as they push doctors to unilaterally cut opioid prescriptions.

“As physicians today execute a hard shift on opioids, I plead for caution,” Kertesz wrote. “Patients with chronic pain report enormous suffering, some committing suicide as they see their lives turned upside down by doctors pressured to reduce.”

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