Physicians' attitudes toward pain and the use of opioid analgesics: results of a survey from the Texas Cancer Pain Initiative.
BACKGROUND
Despite extensive progress in the scientific understanding of pain in humans, serious mismanagement and undermedication in treating acute and chronic pain is a continuing problem. This study was designed to examine the barriers to adequate pain management, especially as they might be associated with community size and medical discipline.


METHODS
A 59-item survey was used to measure physicians' attitudes, knowledge, and psychologic factors that contribute to pain management practices.


RESULTS
Overall, a significant number of physicians in this survey revealed opiophobia (prejudice against the use of opioid analgesics), displayed lack of knowledge about pain and its treatment, and had negative views about patients with chronic pain. There were significant differences among groups of physicians based on size of geographic practice area and medical discipline.


CONCLUSIONS
New educational strategies are needed to overcome these barriers and to improve pain treatment in routine medical practice. The effect of practice milieu must be taken into consideration.
Weinstein
S M
SM
Department of Neuro-Oncology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
Laux
L F
LF
Thornby
J I
JI
Lorimor
R J
RJ
Hill
C S
CS
Thorpe
D M
DM
Merrill
J M
JM
D000208:Acute Disease; D000367:Age Factors; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D002908:Chronic Disease; D002983:Clinical Competence; D004363:Drug Utilization; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence; D004501:Education, Medical; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000503:physiopathology; D009293:Opioid-Related Disorders; D010146:Pain / Q000188:drug therapy* / Q000503:physiopathology; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology; D011156:Population Density; D011287:Prejudice; D011365:Professional Practice Location; D012737:Sex Factors; D013038:Specialization; D013781:Texas
D000701:Analgesics, Opioid