Opioid analgesics for pain control: wisconsin physicians' knowledge, beliefs, attitudes, and prescribing practices.
OBJECTIVE
Opioid analgesics are the drugs of choice for the treatment of moderate to severe acute and cancer pain. Although their role in the management of chronic pain not related to cancer is controversial, there is increasing evidence for their benefit in certain patient populations.


METHODS
A 32-item survey to assess Wisconsin physicians' knowledge, beliefs, and attitudes toward opioid analgesic use was mailed to 600 randomly selected licensed physicians, resulting in a 36% response rate.


RESULTS
Half of the respondents considered diversion a moderate or severe problem in Wisconsin. A majority considered addiction to be a combination of physiological and behavioral characteristics, rather than defining it solely as a behavioral syndrome. Most physicians felt it lawful and acceptable medical practice to prescribe opioids for chronic cancer pain, but only half held this view if the pain was not related to cancer. Fewer physicians considered such prescribing as lawful and generally accepted medical practice if the patient had a history of substance abuse. About two-thirds of physicians were not concerned about being investigated for their opioid prescribing practices, but some admitted that fear of investigation led them to lower the dose prescribed, limit the number of refills, or prescribe a Schedule III or IV rather than a Schedule II opioid.


CONCLUSIONS
Wisconsin physicians who responded to this survey held many misconceptions about the prescribing of opioids. Such views, coupled with a lack of knowledge about laws and regulations governing the prescribing of controlled substances, may result in inadequate prescribing of opioids with resultant inadequate management of pain.
Wolfert
Marla Z
MZ
University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin WI 53792, USA. mwolfert@uic.edu
Gilson
Aaron M
AM
Dahl
June L
JL
Cleary
James F
JF
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D002908:Chronic Disease; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D006077:Government Agencies; D017408:Guidelines as Topic; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007880:Legislation, Drug; D009293:Opioid-Related Disorders / Q000453:epidemiology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010148:Intractable Pain / Q000188:drug therapy; D010820:Physicians; D011795:Surveys and Questionnaires; D014922:Wisconsin / Q000453:epidemiology
D000701:Analgesics, Opioid