Many Physicians Don’t Understand Key Facts about Prescription Opioid Addictions

Rob Wipond
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A Johns Hopkins Bloomberg School of Public Health survey of 1000 US primary care physicians found that many do not understand important facts about the addictive nature of the opioids they are prescribing or about how people become addicted to them. The study was published in The Clinical Journal of Pain.

“One-third of the doctors erroneously said they believed that most prescription drug abuse is by means other than swallowing the pills as intended,” stated a press release about the study, adding that, “Numerous studies have shown that the most common route by which drugs of abuse are administered is ingestion, followed by snorting and injection, with the percentage of those ingesting the drugs ranging from 64 percent to 97 percent, depending on the population studied.”

The study also reported that “nearly half of the internists, family physicians and general practitioners surveyed incorrectly thought that abuse-deterrent pills — such as those formulated with physical barriers to prevent their being crushed and snorted or injected — were actually less addictive than their standard counterparts. In fact, the pills are equally addictive.”

The authors further stated that 25% of physicians “reported being not at all or only slightly concerned about the potential for opioid diversion from the licit to the illicit market when this practice is in fact common at all levels of the pharmaceutical supply chain.”

Most of the physicians supported more clinical and regulatory control of opioids, however.

“Physicians and patients may mistakenly view these medicines as safe in one form and dangerous in another, but these products are addictive no matter how you take them,” the lead author said in the press release. “Doctors continue to overestimate the effectiveness of prescription pain medications and underestimate their risks, and that’s why we are facing such a public health crisis.”

Hwang, Catherine S., Lydia W. Turner, Stefan P. Kruszewski, Andrew Kolodny, and G. Caleb Alexander. “Primary Care Physicians’ Knowledge And Attitudes Regarding Prescription Opioid Abuse and Diversion:” The Clinical Journal of Pain, June 2015, 1. doi:10.1097/AJP.0000000000000268. (Abstract)

Many doctors misunderstand key facets of opioid abuse, study shows (Johns Hopkins Bloomberg School of Public Health press release on ScienceDaily, June 23, 2015)

11 COMMENTS

  1. It’s not just the opioids that they’re not very informed about. This same attitude is true for many of the drugs that doctors prescribe. It seems to me that they must be getting most of their facts from drug reps and we all know how reputable many drug reps are. Doctors are pushing statins on people right and left, without seeming to know that many statins cause muscle problems in the legs, causing people to lose the ability to walk on their own without the aid of crutches or walkers. Statins are not as safe as most people believe but you wouldn’t know it to listen to the gp running around out there.

    • And if this is the case with these two categories of drugs, how many other categories are they not informed about? I’ve heard the excuse that knowing about all the drugs in use is impossible for one person to accomplish but I don’t think that I’d rely much on what is told to me by people whose salaries and bonuses are based on how many drugs they can get doctors to prescribe. They’re jobs are dependent on pushing drugs on doctors so that the doctors can push them on us.

  2. I know not one doctor I dealt with was able to comprehend that a synthetic opioid could cause odd thoughts. None of them knew antidepressants had long run adverse discontinuation symptoms. None new NSAIs could cause confusion in a person. Absolutely not, they all declared! You have bipolar! Then none knew that massive tranquilization with numerous neuroleptics could cause anticholinergic intoxication syndrome, which emulated the symptoms of bipolar / schizophrenia.

    What is the purpose of doctors? To make people sick so they can defraud money from your health insurance company?

  3. I’ve also observed that many, many physicians are poorly informed about drugs. I’ve seen them inappropriately prescribe antidepressants, statins, antibiotics, and sleep aids, not to mention Ritalin, and antipsychotics. I too wonder if they get most of their information on drugs from pharmaceutical company reps. But even if they don’t, there is a tremendous amount of misinformation on drugs to be found in medical journals that publish drug company influenced studies and on popular websites that I believe have been influenced directly or indirectly by pharmaceutical companies. These companies also pay physicians who they identify as opinion leaders to try to promote their drugs to other physicians.

    • They can’t even handle antibiotics. I stopped counting how many times I was prescribed an antibiotic for a viral infection and not prescribed one for a clearly bacterial one.
      Medical doctors lack basic biological knowledge and very often are not interested in understanding what is that they actually do with a given drug or procedure. It may work in some cases if just by chance you have something “standard” but sure as hell you may also get yourself killed by trusting them too much.

      • You are absolutely right. They prescribe antibiotics at the drop of a hat for way too many things that wont be helped by antibiotics. They’re creating super bacteria that can’t be touched with the normal antibiotics and a lot of times not even the strongest antibiotics are of any help. We are creating a monster that will come back to bite us in the butt in the future. But, people run to the doctor all the time and want an antibiotic so we’re too blame for a lot of this.

        • Stephen,

          I had minor surgery a few months ago in which doctors routinely prescribe antibiotics prophalactically after the surgery in spite of the lack of supporting evidence. Fortunately, my surgeon agreed I didn’t have to take them and I never came close to developing any infections. In case people were wondering why I worried about his reaction, I just felt like if I couldn’t have an honest discussion about medications, then he was the wrong doctor for me.

          Anyway, this experience makes me wonder how many times antibiotics are prescribed prior to and after surgery when the evidence doesn’t support the practice and thus contributes to the problem of super antibiotics. I know many doctors would say a short time course doesn’t do this but I do wonder about that.

          • I was wondering how your surgery turned out since I remember you referring to the possibilities of it a while back. Glad that things went well since I had the feeling that you were a little stressed about it.

            Another problem with antibiotics is that people begin a round of them for a particular problem and then quit before they finish the entire regimen due to the fact that they’re feeling better. I’m sure that you know that all this does is make the bacteria that they were trying to kill out stronger because they adapt to the low levels of antibiotic. There are strains of very dangerous bacteria now that almost can’t be stopped even with the most potent of antibiotics. But, as your statement shows, the doctors just keep on handing out those antibiotics.

  4. It must be an excellent education system that produces doctors who have no f***ing clue what opioids are and how they work on people. One would think that an averagely intelligent teen should know that. These are not brand new drugs that have never been used before – you don’t have to study medicine to know they’re freaking addictive in any way shape or form if you only read some XIXth century novels.

    It’s really depressing. If they don’t know what ones of the most famous drugs do to a human than I don’t want to know what is their knowledge on anything more cutting edge than a morphine derivative.