Physicians Have Feared Violence After Refusing to Write Opioid Prescriptions

A new survey highlights the ways that physicians and pharmacists say the opioid epidemic has changed their prescribing or prescription filling behavior.

Improving prescriber training and education around opioid prescribing is among the dozens of recommendations set forth in the final report of the President’s Commission on Combating Drug Addiction of the Opioid Crisis, issued this week.

But for prescribers and pharmacists on the front lines of dealing with patients, other factors beyond education may be at play in their prescribing decisions.

According to a new survey by Medscape, most physicians and pharmacists have refused to write or fill an opioid prescription for a patient. But doing so made 62% of pharmacists and half of physicians fearful that the patient who wanted to prescription would act violently against them for refusing.

In addition, 40% of physicians and half of pharmacists are now more concerned about legal action taken against them regarding opioids, such for liability in an overdose death.

Those are just two of the ways that physicians and pharmacists say the opioid epidemic has changed their prescribing or prescription filling and other behaviors, according to the survey, which polled physicians and pharmacists online.

Overall, the poll showed that the opioid epidemic has:

• Changed prescribing habits of 73% of physicians
• Changed the prescription filling habits of 82% of pharmacists
• Had had no impact on prescribing habits of 16% of physicians
• Had had no impact on filling habits of 7% of pharmacists

The poll also shed some light on respondents use of and views about prescription drug monitoring programs (PDMP).

It found that 87% of pharmacists and 73% of physicians said they used a PDMP, and most—75% of pharmacists and 70% of physicians—said that PDMPs had a positive effect on changing habits.

Other research has showed that many PDMPs are onerous to use, resulting in many prescribers not using them.

Yale New Haven Health and Yale School of Medicine are attempting to change that by integrating its EHR with the Connecticut Prescription Monitoring and Reporting System.