Improving Pain Management Communication: How Patients Understand the Terms “Opioid” and “Narcotic”

Abstract

BACKGROUND/OBJECTIVES: Pain specialists often advocate discontinuing use of the term "narcotic," with the negative connotations it bears for many patients, in favor of the term "opioid." To contribute empirical data to this argument, we elicited and compared patient understandings of the terms "narcotic" and "opioid." DESIGN/PARTICIPANTS: Brief, anonymous surveys were administered to 100 outpatients. Respondents were asked to describe what a narcotic/opioid is, give example(s), explain why someone would take a narcotic/ opioid and describe long term consequences of use. RESULTS:Of the 100 outpatients, 86% responded "don't know" to all four opioid questions. Only 12% did not know what a narcotic was (p<001). While 50% of patients related "narcotics" to pain management, more than a third cited addiction or abuse. Of the 100 outpatients, 78% feared an adverse outcome from long-term narcotic use, with 66% of those answers citing "addiction."CONCLUSION: Most patients were unfamiliar with the term opioid, while a substantial percentage identified a narcotic as an illegal drug and most reported adverse consequences as the outcome of long term use. Our findings, while preliminary, suggest that "opioid" is a more unfamiliar term, but raise questions about whether simply using different terminology would affect patient fears about this class of medications.

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

“…Many patients do not have an opinion about "opioids" or know what this term means (167). Most are familiar with the term "narcotics."…”

Terminology Matters: Patient Understanding of “Opioids” and “Narcotics”

“…Consistent with the data collection procedures employed by Mangoine et al., 18 two questionnaire versions were created, one using “narcotic” and the other using “opioid.” Participants were randomized, using a computer‐generated sequence with permuted blocks of 10, to receive either the “narcotic” or “opioid” questionnaire version. Random assignment was concealed from the assessor by placing a photocopy of either the “narcotic” or “opioid” questionnaire version into a beige manila file folder.…”

“…While patient understanding of the terms “narcotics” and “opioids” has been explored among a predominantly male veteran patient population, 18 to our knowledge, this issue has not been addressed in other sociodemographically diverse patient populations. Therefore, to address this gap in the literature, the purpose of this study was to compare and contrast understanding of “narcotics” and “opioids” among a sample of young women seeking care at a primary care clinic in the Southeastern, United States.…”

Navigating Challenging Conversations About Nonmedical Opioid Use in the Context of Oncology

“…Stigma is closely connected to the language we use when speaking about SUDs. Frequently the terms “abuser,” “addict,” “drug seeking,” “narcotic,” and “dirty” are used to describe people with a SUD or to denote the presence of unprescribed medications or illicit substances in a urine sample . Abuse is a highly charged term, associated frequently with rape, domestic violence, and child molestation .…”