85% Of U.S. Doctors Suspect Their Patients Abuse Opioids

Survey shows 77% list medical marijuana as least preferred alternative

MASSACHUSETTS:  The opioid epidemic causes more than 100 overdoses daily in America and fewer than 1 in 5 treating physicians approve of the government’s handling of the crisis. These findings are from a new survey of 501 physicians conducted by InCrowd and McLean Hospital.

“The doctors we surveyed showed incredible passion for this topic—they had significant insight into fixing it,” says Danielle Schroth, InCrowd’s Director of Crowd Development. “They’re frustrated that they can’t do enough for their patients’ wellbeing.”

“Part of what got us into this current crisis was physician behavior, well-meaning physician behaviors,” says Rocco Iannucci, MD, of McLean Hospital’s Division of Alcohol and Drug Treatment. “The survey uncovered physicians’ pressures towards treating pain and addiction.”

The survey fielded by InCrowd, pioneer of real-time life science market intelligence, and McLean Hospital’s Division of Alcohol and Drug Treatment Programming, also found:

  • Nearly half (47%) disapprove of the federal government’s response
  • Forty-four percent called for stricter regulations to curb opioid abuse, while 18% wanted to discontinue opioid prescriptions all together
  • Ten percent wanted to end patient satisfaction surveys, which put pressure on physicians for positive patient ratings
  • Nonsteroidal anti-inflammatory drugs (NSAIDS) are the most preferred treatment alternative (68%), followed by lifestyle changes.

“There is limited education historically on treatment of pain,” says Dr. Iannucci. “So, doctors may only be familiar with a few things—perhaps Tylenol, ibuprofen, and then they move to opioids. More systematic education of medical students and residents in all specialties, and not just in pain specialization, is really important.”

Citing Themselves as a Top Factor in Prescribed Opioid Abuse, 73% of US Physicians Want More Alternative Therapies And Less Meds

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.