MASSACHUSETTS: US physicians who prescribe opioid pain medications are owning their role in today’s opioid abuse while citing structural problems that feed the issue, and calling for more alternative therapies integrated with medication. The data are from the latest public health perception analysis created by InCrowd, a provider of real-time market intelligence to the life sciences and healthcare firms.
In a microsurvey performed October 27-28 using InCrowd’s technology platform, US physicians including pain management specialists, primary care physicians, and emergency room (ER) doctors who prescribe opioids — cited physician overprescribing for pain management as the single biggest factor in the increased misuse of opioids by patients in the past 5 years, topping the list at 30%. 24% cited patient aggressive drug-seeking behavior, and 18% cited the accessibility of pain medication that is not prescribed.
“We were told for years that (opioids) wouldn’t be addictive in the great majority of patients. This was obviously wrong,” said one ER physician.
Respondents overwhelmingly (73%) wanted alternatives therapies to be integrated into treatment plans instead of a sole focus on medicating pain. 62% said that having a plan at the outset to wean patients off pain medications would help establish expectations with patients that the medication would not be a long-term solution.
Respondent verbatim remarks cited systemic healthcare factors such as the concern that patients could rate doctors lower on CMS-mandated patient satisfaction scores when they decline patient’s request for narcotics. As one primary care physician (PCP) explained, “Doctors are caught in the middle,” between treating pain as the “fifth vital sign” as advised by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) starting in 2000, and not overprescribing. Lack of Medicaid or Affordable Care Act coverage for specialists and for non-medication alternatives leads to PCPs managing patients’ pain and prescriptions instead of a pain management specialist. One physician cited that social media teaches patients “how to use/abuse Rx meds given in compassion to those actually in pain.”
Other data show that:
- Few physicians were heavy opioid prescribers. Only 8% of respondents prescribed opioids for the majority — more than 50% — of their patients. 46% said 5% or less of their patient base was currently being treated with a prescription opioid, while another 46% prescribed them for between 5% and 50% of their patients.
- The majority wanted additional limitations on opioid pain prescribing. 60% of physician respondents wanted more frequent evaluations of patients taking a prescribed opioid, while 59% wanted smaller quantities of pain medications in each prescription refill.
- Marijuana ranked the lowest of all alternative treatment options that were currently prescribed by respondents, cited by just 10% of respondents. Non-habit forming pain medication topped the list, cited by 82%, followed by physical therapy, at 80%. Exercise (72%), mental health treatment (48%), and vitamin and herbal treatments (20%) were also prescribed.
“Physicians show extreme frustration with the entire healthcare system when it comes to the opioid crisis,” said Diane Hayes, president and cofounder of InCrowd. “Their vote for sweeping healthcare change as reflected by the data should be a rallying cry to make this a top national priority in 2017.”
The opioid epidemic microsurvey included responses from 225 US-based, triple-verified, board-certified physicians in primary care, pain management and emergency medicine who have prescribed opioid pain medications to their patients. Respondents have been in practice an average of 25 years and came in equal parts from major regions of the US. They responded to a 4-question microsurvey using InCrowd’s real time market insights platform on October 27-28, 2016.