Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction?

Dineen, Kelly K.; DuBois, James M.

doi:10.1177/0098858816644712

Cited by 56 publications

(36 citation statements)

References 102 publications

(72 reference statements)

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“…This gap in treatment access may reflect provider distancing from patients stereotyped as "difficult," dangerous, or being involved in criminalized behaviors [85,86]. Other providers may wish to avoid the legal scrutiny associated with being a considered a "pill mill" (e.g., DEA audits) [87] or to avoid the courtesy stigma attached to caring for patients with OUDs [86,88]. Stigma has also undermined the wider distribution of overdose education and naloxone in the community.…”

Section: The Us Opioid Overdose Crisis Response: Multiple Levels Of Pmentioning

confidence: 99%

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

et al. 2019

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• The current United States opioid overdose crisis is a complex, multifaceted, public health emergency that urgently requires the implementation of evidence-based primary, secondary, and tertiary preventive interventions. We develop a typology of the stigma related to opioid use, showing how multiple dimensions of stigma continue to fundamentally hinder the response to the crisis. • Public stigma is driven by stereotypes about people with opioid use disorders, such as their perceived dangerousness or perceived moral failings, which translate into negative attitudes toward people with opioid use disorders. • Enacted stigma describes the behavioral manifestations of public stigma, including discrimination and social distancing. Public and enacted stigma, in turn, lead to delivery of suboptimal care and undermine access to treatment and harm reduction services. • Public stigma and enacted stigma can become structural stigma when they become encoded in cultural norms, laws, and institutional policies. Collectively, these forms of stigma run at cross purposes to-and reduce public support for-public health-oriented policies to address the opioid overdose crisis.

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Section: The Us Opioid Overdose Crisis Response: Multiple Levels Of Pmentioning

confidence: 99%

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

et al. 2019

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“…Eleven articles offered no definition of trust (Burgess et al, 2008;Chibnall, Tait, & Gammack, 2018;Dineen & Dubois, 2016;Diniz, Madeiro, & Rosas, 2014;Kennedy et al, 2017;Langley & Klopper, 2005;Lindberg, Bjoorn, Karlen, & Oxelmark, 2013;Losin, Anderson, & Wager, 2017;Matthias et al, 2013;Merrill, Rhodes, Deyo, Marlatt, & Bradley, 2002;Sun et al, 2018). These articles addressed trust secondarily, except for Sun et al's (2018) study of relations between resilience and physicians' trust.…”

Section: Theoretical and Methodological Approachesmentioning

confidence: 99%

Healthcare professionals' trust in patients: A review of the empirical and theoretical literatures

2020

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Trust is considered as an important process in establishing positive patient-professional relationships and healthcare outcomes. While many studies denote the mutualreciprocal nature of trust, there is a strong tendency to consider professionals merely as trustees. This article presents a review of literature addressing healthcare professionals' trust in patients, aiming to identify and compare more theoretical and more empirical contributions on the topic as a basis for developing a research agenda. We examine 31 theoretical and empirical peer-reviewed articles that address healthcare professionals' trust in patients, either as the primary or secondary focus. We found that healthcare professionals' trust in patients is still overlooked in empirical trust studies into healthcare, despite several theoretical and review articles emphasising the relevance of the topic. We propose that future empirical research considers professionals' uncertainties and vulnerabilities, and that theoretical studies reflect more on methodological approaches for researching their conceptualisations. Moreover, our findings suggest that while system-based understandings have been seen as important for considering how patients trust in their healthcare, we argue that This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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“…Yet despite reports of physician fears regarding opioid prescribing (Dineen & DuBois, 2016), in the decade from 2002 – 2011, approximately 25 million people initiated nonmedical use of prescription opioids (Dart et al, 2015). In 2010, deaths attributed to nonmedical use of prescription opioids exceeded 16,000 (Dart et al, 2015).…”

mentioning

confidence: 99%

“…The 4Ds are: dated physicians misprescribe due to obsolete information; disabled physicians are impaired by their own use of psychoactive drugs; dishonest physicians use their license to deal drugs; and duped physicians are tricked into prescribing medically unnecessary opioids (Council on Scientific Affairs, 1982; Wesson & Smith, 1990). The last category in this list suggests that a physician may make a good faith effort to practice according to standards of care, yet be “duped” by a clever patient into behaving in a manner that creates risk of criminal prosecution or loss of medical licensure (Dineen & DuBois, 2016)…”

mentioning

confidence: 99%

A Mixed-Method Analysis of Reports on 100 Cases of Improper Prescribing of Controlled Substances

DuBois

Chibnall

Anderson

et al. 2016

Journal of Drug Issues

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Improper prescribing of controlled substances contributes to opioid addictions and deaths by overdose. Studies conducted to-date have largely lacked a theoretical framework and ignored the interaction of individual with environmental factors. We conducted a mixed-method analysis of published reports on 100 cases that occurred in the United States. An average of 17 reports (e.g., from medical boards) per case were coded for 38 dichotomous variables describing the physician, setting, patients, and investigation. A theory on how the case occurred was developed for each case. Explanatory typologies were developed and then validated through hierarchical cluster analysis. Most cases involved physicians who were male (88%), >40 years old (90%), non-board certified (63%), and in small private practices (97%); 54% of cases reported facts about the physician indicative of self-centered personality traits. Three explanatory typologies were validated. Increasing oversight provided by peers and trainees may help prevent improper prescribing of controlled substances.

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Between a Rock and a Hard Place: Can Physicians Prescribe Opioids to Treat Pain Adequately While Avoiding Legal Sanction?

Cited by 56 publications

References 102 publications

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

Stigma as a fundamental hindrance to the United States opioid overdose crisis response

Healthcare professionals' trust in patients: A review of the empirical and theoretical literatures

A Mixed-Method Analysis of Reports on 100 Cases of Improper Prescribing of Controlled Substances

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