Assessment of physiatrists' knowledge and perspectives on the use of opioids: Review of basic concepts for managing chronic pain

Previous studies of physicians have elucidated knowledge gaps and misconceptions about the use of opioids for the treatment of chronic pain. The recent approval of a pain management subspecialty certification for physiatrists will create higher expectations of the field regarding the treatment of chronic pain. Five hundred randomly chosen physiatrists were surveyed with a 50.6% response rate. Ninety-eight percent of respondents treat patients with chronic noncancer pain diagnoses, and 37% occasionally treat patients with cancer-related pain. Seventy percent of respondents underestimated the percentage of patients with cancer-related pain that could experience relief with oral analgesics. Only 17% underestimated the percentage of advanced cancer patients that experience significant pain. Eight percent of respondents incorrectly answered that a patient, regardless of diagnosis, would become addicted to opioids by taking an opioid daily. Only 25% identified the correct definition of addiction. Questions regarding side effects revealed that 10% of respondents incorrectly believed that opioid-induced respiratory depression is common in patients whose oral morphine dose exceeds 100 mg per day. Eighty percent of respondents preferred long-acting preparations, and 92% preferred set dosing schedules for the treatment of chronic pain. Rapidly evolving concepts regarding the implementation of pharmacologic regimens for chronic pain diagnoses require health care professionals who are trained to administer these treatments. Overall, the survey results are encouraging regarding physiatrists' knowledge about the use of opioids to treat patients with chronic pain.