Volume 44 Number 2 2007
Pages 263 — 270

Abstract - Medical residents' beliefs and concerns about using opioids to treat chronic cancer and noncancer pain: A pilot study

Craig S. Roth, MD;1-3* Diana J. Burgess, PhD;2-3 Maren L. Mahowald, MD1-2

1Department of Medicine, Minneapolis Department of Veterans Affairs (VA) Medical Center, Minneapolis, MN; 2Department of Medicine, University of Minnesota, Minneapolis, MN; 3VA Center for Chronic Disease Outcomes Research, Minneapolis, MN

Abstract — This study assessed and compared residents' beliefs and concerns about using opioids for treating pain in patients with cancer and noncancer low back pain (NLBP). Participants included 72 Internal Medicine and Medicine-Pediatrics residents who completed a survey questionnaire. Based on a scale of 0 = "No concern" to 10 = "Very concerned," residents expressed greater concern that treating NLBP with opioids, compared with cancer-related pain, causes addiction (6.01 vs 1.15), abuse (5.57 vs 1.39), and side effects (4.76 vs 2.87); limits other treatments (5.36 vs 1.30); draws criticism from faculty (4.33 vs 0.88); or risks sanctioning (state board 4.12 vs 1.12, legal 4.06 vs 1.17); p < 0.001 for each (paired t-tests). They had more comfort (8.94 vs 4.31) and more empathy (9.09 vs 6.79) using opioids to treat for cancer pain than NLBP and would give whatever doses necessary for pain control (8.41 vs 3.66); p < 0.001 for each. Our findings show that residents are far more concerned about using opioids to treat NLBP than cancer-related pain.

Key words: addiction, analgesics, cancer pain, chronic pain, low back pain, noncancer, opioids, pain, physician attitudes, psychological, resident education, treatment.

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