Between “opioidophobia” and the opioid crisis: a cross-sectional comparison of opinions on opioid analgesic treatment between palliative care patients with cancer and physicians in Poland

Abstract

Introduction. Inadequate pain control may contribute to a desire to die. Early use of opioid analgesics could improve pain treatment. On the other hand, opioids are associated with risk of addiction. We aimed to compare the opinions on opioid analgesic use between palliative care patients and physicians. Material and methods. Data on the opinions of hospice and palliative care patients (n = 104) and physicians of different specialties (n = 216) were collected using a survey with closed-ended questions scored on a 5-point Likert scale. Results. The majority (87.5%) of cancer patients experienced pain during their illness (mean intensity: 7.01±2.44). More than half (53.3%) of physicians had concerns that patients overuse opioid drugs. Negative connotations associated with the word "morphine" were expressed in both study groups. Survey responses of both patients and physicians were consistent with the phenomenon of "opioidophobia". Conclusions. We found a high degree of consensus between cancer patients' and physicians' opinions on opioid analgesic use. However we also found some discrepancies in opinions and they were mostly related to medical knowledge, which may indicate poor patient education about opioid use and poor communication between patients and physicians. It is concerning to note these significant discrepancies concerning opioid use since patients considered opioids useful in ensuring pain relief and improving their quality of life. The majority (almost 90%) of patients surveyed struggled with pain over the course of their illness and treatment.