“The DEA would come in and destroy you” : a qualitative study of fear and unintended consequences among opioid prescribers in WV
Sedney, Cara L. ; Haggerty, Treah ; Dekeseredy, Patricia ; Nwafor, Divine ; Caretta, Martina Angela LU
; Brownstein, Henry H.
and Pollini, Robin A.
(2022)
In Substance Abuse: Treatment, Prevention, and Policy
17.
- Abstract
Background: West Virginia has one of the highest rates of opioid overdose related deaths and is known as the epicenter of the opioid crisis in the United States. In an effort to reduce opioid-related harms, SB 273 was signed in 2018, and aimed to restrict opioid prescribing in West Virginia. SB 273 was enacted during a time when physician arrests and convictions had been increasing for years and were becoming more prevalent and more publicized. This study aims to better understand the impact of the legislation on patients and providers. Methods: Twenty semi-structured interviews were conducted with opioid-prescribing primary care physicians and specialists practicing throughout West Virginia. Results: Four themes emerged, 1. Fear of... (More)
Background: West Virginia has one of the highest rates of opioid overdose related deaths and is known as the epicenter of the opioid crisis in the United States. In an effort to reduce opioid-related harms, SB 273 was signed in 2018, and aimed to restrict opioid prescribing in West Virginia. SB 273 was enacted during a time when physician arrests and convictions had been increasing for years and were becoming more prevalent and more publicized. This study aims to better understand the impact of the legislation on patients and providers. Methods: Twenty semi-structured interviews were conducted with opioid-prescribing primary care physicians and specialists practicing throughout West Virginia. Results: Four themes emerged, 1. Fear of disciplinary action, 2. Exacerbation of opioid prescribing fear due to restrictive legislation, 3. Care shifts and treatment gaps, and 4. Conversion to illicit substances. The clinicians recognized the harms of inappropriate prescribing and how this could affect their patients. Decreases in opioid prescribing were already occurring prior to the law implementation. Disciplinary actions against opioid prescribers resulted in prescriber fear, which was then exacerbated by SB 273 and contributed to shifts in care that led to forced tapering and opioid under-prescribing. Providers felt that taking on patients who legitimately required opioids could jeopardize their career. Conclusion: A holistic and patient-centered approach should be taken by legislative and disciplinary bodies to ensure patients are not abandoned when disciplinary actions are taken against prescribers or new legislation is passed.
(Less)
- author
- Sedney, Cara L.
; Haggerty, Treah
; Dekeseredy, Patricia
; Nwafor, Divine
; Caretta, Martina Angela
LU
; Brownstein, Henry H.
and Pollini, Robin A.
- organization
- publishing date
- 2022-12
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Chronic pain, Legislation, Opioids, Pain medication
- in
- Substance Abuse: Treatment, Prevention, and Policy
- volume
- 17
- article number
- 19
- publisher
- BioMed Central (BMC)
- external identifiers
-
- pmid:35272687
- scopus:85126213404
- ISSN
- 1747-597X
- DOI
- 10.1186/s13011-022-00447-5
- language
- English
- LU publication?
- yes
- id
- 7730b9ab-4948-406e-92d1-4a816acd9909
- date added to LUP
- 2022-05-23 14:53:32
- date last changed
- 2024-04-18 07:32:51
@article{7730b9ab-4948-406e-92d1-4a816acd9909,
abstract = {{<p>Background: West Virginia has one of the highest rates of opioid overdose related deaths and is known as the epicenter of the opioid crisis in the United States. In an effort to reduce opioid-related harms, SB 273 was signed in 2018, and aimed to restrict opioid prescribing in West Virginia. SB 273 was enacted during a time when physician arrests and convictions had been increasing for years and were becoming more prevalent and more publicized. This study aims to better understand the impact of the legislation on patients and providers. Methods: Twenty semi-structured interviews were conducted with opioid-prescribing primary care physicians and specialists practicing throughout West Virginia. Results: Four themes emerged, 1. Fear of disciplinary action, 2. Exacerbation of opioid prescribing fear due to restrictive legislation, 3. Care shifts and treatment gaps, and 4. Conversion to illicit substances. The clinicians recognized the harms of inappropriate prescribing and how this could affect their patients. Decreases in opioid prescribing were already occurring prior to the law implementation. Disciplinary actions against opioid prescribers resulted in prescriber fear, which was then exacerbated by SB 273 and contributed to shifts in care that led to forced tapering and opioid under-prescribing. Providers felt that taking on patients who legitimately required opioids could jeopardize their career. Conclusion: A holistic and patient-centered approach should be taken by legislative and disciplinary bodies to ensure patients are not abandoned when disciplinary actions are taken against prescribers or new legislation is passed.</p>}},
author = {{Sedney, Cara L. and Haggerty, Treah and Dekeseredy, Patricia and Nwafor, Divine and Caretta, Martina Angela and Brownstein, Henry H. and Pollini, Robin A.}},
issn = {{1747-597X}},
keywords = {{Chronic pain; Legislation; Opioids; Pain medication}},
language = {{eng}},
publisher = {{BioMed Central (BMC)}},
series = {{Substance Abuse: Treatment, Prevention, and Policy}},
title = {{“The DEA would come in and destroy you” : a qualitative study of fear and unintended consequences among opioid prescribers in WV}},
url = {{http://dx.doi.org/10.1186/s13011-022-00447-5}},
doi = {{10.1186/s13011-022-00447-5}},
volume = {{17}},
year = {{2022}},
}