Health professional perceptions of opioid dependence among patients with pain

The purpose of this study was to determine the percentage of patients perceived by health professionals to be opioid dependent among all patients presenting with pain and specifically among sickle cell patients with pain. Surveys were completed by all staff, residents, and nurses at an urban teaching hospital with an emergency department population consisting primarily of lower socioeconomic patients of African-American origin. The surveys requested a percentage estimate of all pain patients and sickle cell patients with pain presenting to this hospital who they perceived to be opioid dependent. The estimated percentage of opioid dependent patients presenting to the emergency department with pain was 4% for staff (P< .05, N = 14), 9% for residents (n = 31), and 7% for nurses (n = 41), and the estimates for sickle cell patients presenting with pain only were 8%, 17%, and 13% respectively (P< .05). All health professional groups surveyed estimated opioid dependence in patients with pain far in excess of that shown in previous studies. It is unknown whether pain medication are withheld inappropriately by physicians who perceived patients with pain to be opioid dependent, and that this deserved further study especially among sickle cell patients.