Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

Zallman, Leah; Rubens, Sonia L.; Saitz, Richard; Samet, Jeffrey H.; Lloyd‐Travaglini, Christine; Liebschutz, Jane M.

doi:10.1155/2012/167062

Cited by 7 publications

(6 citation statements)

References 31 publications

(46 reference statements)

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“…It is important to note that many of the patients who wanted more priority placed on discussing pain, as well as those who expressed desire for their pain to be recognized as real, were not seeking to discuss opioids; many were in fact avoiding opioids and looking for a sympathetic ear, while others wanted answers to questions about the origins and implications of their pain symptoms. Indeed, prior research has demonstrated that especially for patients with substance abuse disorders, concerns about addiction and side effects can be barriers to the use of opioid therapy . If PCPs conclude that those patients who want to discuss pain necessarily want to discuss opioids, there may be a tendency for conversations about pain to be approached more hesitantly or even delayed until the patient–provider relationship is perceived as more well defined.…”

Section: Discussionmentioning

confidence: 99%

Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study: Table 1

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study: Table 1

et al. 2013

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“…51 Meanwhile, patients with co-occurring pain and addiction may be wary of accurately reporting their pain and addiction behaviors, especially if they believe their clinician will discontinue their opioid prescription or engage in stigmatizing behaviors. 10,60,106…”

Section: Intersecting Stigmasmentioning

confidence: 99%

Framework for opioid stigma in cancer pain

Bulls

Chu

Goodin

et al. 2021

Pain

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Millions of patients with cancer pain are treated with prescription opioids each year. However, efforts to mitigate the ongoing opioid crisis result in unintended consequences with opioid pain management, including opioid stigma. Emerging research indicates that opioid stigma is problematic in patients with cancer, but few studies have examined contributors to and impacts of opioid stigma in this population. To guide future research in this area, we propose a conceptual framework—the opioid stigma framework (OSF)—with which to understand and improve opioid stigma in patients with cancer pain. Development of the OSF was guided by a literature review of stigma in health-related conditions, adaptation of the existing Health Stigma and Discrimination Framework, a topical review of challenges related to opioid cancer pain management, and author expertise in cancer, pain, and opioid prescribing. The proposed OSF highlights 5 domains: (1) contributors to opioid stigma, or factors that increase the likelihood that a patient will experience opioid stigma; (2) intersecting stigmas, or the convergence of multiple stigmatized identities within a patient; (3) stigma manifestations, or the ways opioid stigma is manifested in patients, clinicians, and the community; (4) proximal outcomes, or the immediate consequences of opioid stigma in patients; and (5) long-term impacts in patients. The OSF provides 2 main avenues to facilitate future research: (1) providing a framework to explore the mechanisms that underlie opioid stigma and its impact on cancer pain management and (2) supporting the development of targeted, tailored interventions to eliminate opioid stigma.

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“…Rampant polypharmacy, coupled with lack of awareness, has had a huge impact on analgesic efficacy and presents tolerability issues 40. Several misconceptions regarding use of analgesics and fear of adverse events associated with the use of opioids or surgical methods of analgesia result in suboptimal treatment of pain 41,42. These inadequacies might be overcome by the amalgamation of expert opinions and available evidence to form standardized treatment guidelines for pain therapy.…”

Section: Unmet Needs Of Indiamentioning

confidence: 99%

“… 40 Several misconceptions regarding use of analgesics and fear of adverse events associated with the use of opioids or surgical methods of analgesia result in suboptimal treatment of pain. 41 , 42 These inadequacies might be overcome by the amalgamation of expert opinions and available evidence to form standardized treatment guidelines for pain therapy. Hence, an expert panel was convened to delve on these lacunae and frame an appropriate treatment paradigm for pain management.…”

Section: Unmet Needs Of Indiamentioning

confidence: 99%

Evidence and consensus recommendations for the pharmacological management of pain in India

Dureja¹,

Iyer

Das

et al. 2017

JPR

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Despite enormous progress in the field of pain management over the recent years, pain continues to be a highly prevalent medical condition worldwide. In the developing countries, pain is often an undertreated and neglected aspect of treatment. Awareness issues and several misconceptions associated with the use of analgesics, fear of adverse events – particularly with opioids and surgical methods of analgesia – are major factors contributing to suboptimal treatment of pain. Untreated pain, as a consequence, is associated with disability, loss of income, unemployment and considerable mortality; besides contributing majorly to the economic burden on the society and the health care system in general. Available guidelines suggest that a strategic treatment approach may be helpful for physicians in managing pain in real-world settings. The aim of this manuscript is to propose treatment recommendations for the management of different types of pain, based on the available evidence. Evidence search was performed by using MEDLINE (by PubMed) and Cochrane databases. The types of articles included in this review were based on randomized control studies, case–control or cohort studies, prospective and retrospective studies, systematic reviews, meta-analyses, clinical practice guidelines and evidence-based consensus recommendations. Articles were reviewed by a multidisciplinary expert panel and recommendations were developed. A stepwise treatment algorithm-based approach based on a careful diagnosis and evaluation of the underlying disease, associated comorbidities and type/duration of pain is proposed to assist general practitioners, physicians and pain specialists in clinical decision making.

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Attitudinal Barriers to Analgesic Use among Patients with Substance Use Disorders

Cited by 7 publications

References 31 publications

Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study: Table 1

Contrasting Tensions Between Patients and PCPs in Chronic Pain Management: A Qualitative Study: Table 1

Framework for opioid stigma in cancer pain

Evidence and consensus recommendations for the pharmacological management of pain in India

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