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Chronic Pain Patients Taking Opioids Have Hard Time Finding Care

MONDAY, Feb. 8, 2021 -- Access to primary care is limited for patients taking opioids for chronic pain, particularly for patients with histories suggestive of aberrant use of opioids, according to a study recently published in Pain.

Pooja Lagisetty, M.D., from the University of Michigan in Ann Arbor, and colleagues conducted a secret shopper audit survey of primary care clinics in nine states (May to July 2019). Simulated patients taking opioids for chronic pain called clinics claiming to need a new provider either because their previous physician had retired or stopped prescribing opioids for unspecified reasons. Clinic willingness to see the patient and prescribe opioids was assessed.

The researchers report that 452 clinics responded to both scenarios (904 calls). More than four in 10 clinics (43 percent) said their providers would not prescribe opioids in either scenario, while just under one-third of clinics (32 percent) said their providers might prescribe in both. One-fourth of clinics (25 percent) responded differently to each scenario, with greater willingness to prescribe when the previous doctor retired versus when the doctor had stopped prescribing (odds ratio, 1.83).

"Even if you think that someone is using opioids for a reason other than pain, or that long-term opioids are not an effective pain care strategy, those are exactly the patients we in primary are should be seeing," Lagisetty said in a statement. "Restricting their primary care access limits their ability to engage in pain-focused care and potentially addiction-focused care."

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