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Perceived Need for Training and Skills Development Related to Addiction Risk for Patients with Pain
Perceived Need for Training and Skills Development Related to Addiction Risk for Patients with Pain.
Presented for
AAPM 26th Annual Meeting.
02/03/2010
Abstract: Read full abstract
Introduction: The need for better skills training related to addiction risk associated with pain treatment is understood (CASA, 2005;; Merrill, 2002; Lin, 2007). But data to guide such development so that it emphasizes the greatest need is limited. Materials and Methods: We interviewed six primary care providers about their concerns and challenges in prescribing opioids and treating pain and addiction as well as their needs and preferences regarding continuing medical education (CME) courses on pain and addiction.
Results: The PCPS greatest concern when prescribing opioids to patients was the potential for addiction. Their greatest challenges were: 1) diversion, 2) co-occurring psychiatric disorder, and 3) inability of non-opioid treatments to relieve pain. Some participants felt that additional training would help address these challenges. For treating pain in already-addicted patients, they requested information on: 1) discerning drug-seeking behavior due to addiction vs. under-treated pain, 2) identifying relapse into addiction, 3) urine drug testing, 4) informed consent and treatment agreements, 5) how to take an addiction history, and 6) referral resources and clinical tools to help clinicians identify, interview, and manage addicted patients. Participants expressed the most interest in back pain, fibromyalgia, neuropathy, and osteoarthritis. Their greatest interest for practical skills training was in screening for addiction or interviewing pain patients.
Conclusions: PCPs identify a need for education on the risk of addiction in patients with pain. Meeting that need will require a comprehensive resource addressing multiple skills deficits and tools to help the provider find appropriate resources.
This research is funded by NIDA/NIH contract #HHSN271200800012C
References
1. CASA. Under the counter: The diversion and abuse of controlled prescription drugs in the U.S. The National Center on Addiction and Substance Abuse at Columbia University. 2005.
2. Lin JJ, Alfandre D, Moore C. Physician attitudes toward opioid prescribing for patients with persistent noncancer pain. Clinical Journal of Pain. 2007;23(9):799-803.
3. Merrill JO, Rhodes LA, Deyo RA, Marlatt A, Bradley KA. Mutual mistrust in the medical care of drug users. Journal of General Internal Medicine. 2002;17:327-333.
Abstract: Read full abstract
Introduction: The need for better skills training related to addiction risk associated with pain treatment is understood (CASA, 2005;; Merrill, 2002; Lin, 2007). But data to guide such development so that it emphasizes the greatest need is limited. Materials and Methods: We interviewed six primary care providers about their concerns and challenges in prescribing opioids and treating pain and addiction as well as their needs and preferences regarding continuing medical education (CME) courses on pain and addiction.
Results: The PCPS greatest concern when prescribing opioids to patients was the potential for addiction. Their greatest challenges were: 1) diversion, 2) co-occurring psychiatric disorder, and 3) inability of non-opioid treatments to relieve pain. Some participants felt that additional training would help address these challenges. For treating pain in already-addicted patients, they requested information on: 1) discerning drug-seeking behavior due to addiction vs. under-treated pain, 2) identifying relapse into addiction, 3) urine drug testing, 4) informed consent and treatment agreements, 5) how to take an addiction history, and 6) referral resources and clinical tools to help clinicians identify, interview, and manage addicted patients. Participants expressed the most interest in back pain, fibromyalgia, neuropathy, and osteoarthritis. Their greatest interest for practical skills training was in screening for addiction or interviewing pain patients.
Conclusions: PCPs identify a need for education on the risk of addiction in patients with pain. Meeting that need will require a comprehensive resource addressing multiple skills deficits and tools to help the provider find appropriate resources.
This research is funded by NIDA/NIH contract #HHSN271200800012C
References
1. CASA. Under the counter: The diversion and abuse of controlled prescription drugs in the U.S. The National Center on Addiction and Substance Abuse at Columbia University. 2005.
2. Lin JJ, Alfandre D, Moore C. Physician attitudes toward opioid prescribing for patients with persistent noncancer pain. Clinical Journal of Pain. 2007;23(9):799-803.
3. Merrill JO, Rhodes LA, Deyo RA, Marlatt A, Bradley KA. Mutual mistrust in the medical care of drug users. Journal of General Internal Medicine. 2002;17:327-333.
