Summary: A new study found that many primary care physicians are reluctant to take patients if they find that the patient has been using medical opioids or cannabis for their chronic pain. These findings are in line with previous findings that lack of adequate access to medical care is forcing many chronic pain patients to buy opioids or medical cannabis from the black market.
Studies have continually shown that doctors are hesitant to take patients who use opioids or cannabis for chronic pain management. Of course, here we are talking about medical opioids or cannabis. This has been an ongoing trend for the last few years, as evidenced by previous studies and the latest study done by the University of Michigan.
Chronic pain patients using these medications find it hard to find a primary care physician. In the new study, lead author Mark Biket, MD, surveyed 1000 US physicians from various US states, and the findings were alarming in every way.
The study finally included a survey of 852 physicians. It found that about one-third of primary care physicians would not accept patients who use opioids daily for their chronic pain. Not only that, one-fifth would not accept patients who used prescription opioids for their pain now and then.
Here, it is also worth noticing that the study was only done in states with medical cannabis programs, which means that one can expect doctors to be more willing to accept such patients in these states due to higher awareness. However, things might be even worse in other states.
Things were slightly better with medical cannabis, with 18% of doctors saying that they would not take patients with a history of medical cannabis use. Even worse, 40% said that they would not accept patients if the source of cannabis were unclear or if patients bought it from the black market.
There are a few reasons for raising this concern. Health experts note that there are many legacy patients. They have been taking opioids for chronic pain for years. In such patients, other medications are less likely to provide pain relief. Moreover, many of them are satisfied with their treatment or pain control, so changing treatment is not necessary. However, finding a new doctor for these patients may be challenging.
Further, it is also important to note that though opioid prescription rates are declining, that is not true for medical cannabis. In fact, medical cannabis use is becoming more popular these days.
Perhaps the biggest problem that may arise from this hesitation by doctors to accept this group of patients is that many of them will be forced to buy these substances from the black market. However, this will put them at unnecessary risk. Not only that, this also increases the risk of substance use disorder. It is vital that these patients have access to high-quality medical opioids or cannabis.
This is not the first study to show the hesitance among the doctors. Previous studies also had similar findings.
Not only that, in yet another study, researchers from the University of Michigan found that barely 40% of primary care physicians are willing to treat patients who use opioids. In one of the surveys, they called the doctors for an appointment and said that the patient was taking an opioid Percocet. To the amazement of the researchers, refusal rates to provide an appointment were above 50%.
All this means a lack of sufficient care for many chronic pain patients. It appears that this hesitation is pushing many chronic pain patients to the wrong path. Many of them would buy these drugs from the black market, which can not just increase the risk of substance use disorder but also harm health as many of these drugs sold in the black market have high levels of contaminants. Spreading awareness on using interventional pain management by consulting a chronic pain specialist can reduce the risk of cannabis and opioid abuse.
Source:
Bicket, M. C., Stone, E. M., Tormohlen, K., Pierre, R., & McGinty, E. E. (2024). Access to care for patients with chronic pain receiving prescription opioids, cannabis, or other treatments. Health Affairs Scholar, 2(6), qxae086. https://doi.org/10.1093/haschl/qxae086
