A review of healthcare provider attitudes and beliefs surrounding the prescription of opioids for chronic non-cancer pain.
Safely and effectively prescribing opioid medications, such as oxycontin or morphine, to help manage chronic pain is challenging. It requires healthcare providers to engage their patients in a thoughtful discussion about potential benefits and risks involved. Taking opioid medication can help reduce pain and increase function; however, it could also result in addiction, overdose or death. We would like to gain a better understanding about the knowledge, beliefs, and attitudes that providers hold towards prescribing opioid medication for the management of chronic pain. Canada has nationally endorsed guidelines for prescribing opioids; however, providers often do not follow these guidelines which can result in prescribing too much (increasing risk for addiction) or too few opioids (increasing risk for inadequate pain management). As it turns out, this situation is not unique to chronic pain. Providers often do not follow recommended guidelines when prescribing medication to manage other chronic diseases, such as cardiovascular disease or diabetes. There are many reasons why providers may not follow opioid prescribing guidelines. These may include: 1) belief that the person being treated is more complex than those typically seen; 2) fear of patients developing an addiction; 3) perceived lack of appropriate knowledge to safely prescribe and monitor; 4) over-estimating the benefits of opioid medication for pain; or 5) fear of sanctions from professional regulatory providers. To date, no one has reviewed how healthcare provider knowledge, attitude and beliefs influence the prescription of opioids to manage chronic pain. We propose to review the literature in this area. Results from this review could help providers prescribe opioids in a safe and effective manner. Ultimately, along with other multidisciplinary pain management strategies, this could help prevent opioid-related addiction and mortality while ensuring that chronic pain is well managed.