Patients and Healthcare Professionals Concerned About Prescription Opioid Misuse and Addiction, but Survey Reveals Knowledge Gap on Minimizing Risks & Misuse

WebMD and Medscape release new data on consumer and healthcare professionals' awareness of issues surrounding opioid use as part of commitment to White House effort

Nearly three-quarters of physicians report prescribing fewer opioids due to increased abuse, misuse and diversion

Majority of healthcare professionals (91%) tell patients how and when to take opioids, yet only 55% discuss safe storage and disposal

Consumers less likely than healthcare professionals to think that misuse, addiction, and prescription-sharing occurs with prescription opioid use

Jan 05, 2016, 08:05 ET from WebMD

NEW YORK, Jan. 5, 2016 /PRNewswire/ -- WebMD Health Corp. (NASDAQ: WBMD), the leading source of health information, today announced the results of a new survey showing that consumers and healthcare professionals (HCPs) share concerns about prescription opioid misuse, addiction, and the potential for the drugs to fall into the wrong hands – but fewer than 3 in 5 patients and HCPs discuss safe storage and disposal of the medications, potentially fueling the problem.

The survey, conducted by WebMD and Medscape, is part of a White House initiative calling on public and private organizations, including WebMD and Medscape, to address the issue of prescription drug abuse and heroin use.  The survey found that 88% of healthcare professionals prescribe opioids, (e.g., hydrocodone, oxycodone), mirroring national statistics showing the number of prescriptions in the U.S. skyrocketing from 76 million in 1991 to nearly 207 million in 2013.   This increase, coupled with the survey's finding that 42% of patients who have used an opioid in the past three years say they store their leftover opioids for future use, points toward the development of a national inventory of prescription pain medications in America's medicine cabinets.  With the drugs on hand, there is concern that they may be shared or used for purposes other than prescribed.  According to the National Institute on Drug Abuse (NIDA), the number of people dying from prescription opioid pain reliever overdoses has more than tripled in the past 30 years.    

The new survey data reveals both knowledge gaps and discrepancies, including a disconnect in patient-physician communication about addiction risks, and a lack of patient awareness about appropriate storage and disposal.

Conducted between November and December, the survey obtained responses from 1,887 consumers who visited the desktop or mobile WebMD site, and 1,513 U.S. clinicians who are currently active on Medscape, including physicians, nurse practitioners and physician assistants.

To read the full 2015 WebMD/Medscape Opioid Survey executive summary, providing additional data and expert perspectives, visit:

http://www.medscape.com/viewarticle/856589

Or

http://www.webmd.com/mental-health/addiction/news/20151229/opioid-survey

To view a video further showcasing the survey data, visit: http://videostorage.prnewswire.com/storage2/download/77225_Opioid_1080_MP4.zip 

Patterns of Opioid Prescribing and Use
The majority of consumers (63%) have used a prescription opioid in their lifetime, with more than a third (35%) in the past three years. While the majority of healthcare professionals (88%) have prescribed an opioid, physicians' willingness to prescribe has declined, with 69% reporting reduced opioid prescribing (a reduction borne out in IMS Health data, which revealed a decline in opioid prescriptions by 2 million in 2012 and 10 million fewer in 2013). 

Patients who used a prescription opioid in the past three years say they received them from their primary care provider (42%), a specialist (41%), or a dental/oral surgeon (14%).  Twenty-three percent received the prescription from a pain medicine specialist and another 27% of patients received the prescription after a hospital visit (including ER).

Most of the respondents who reported taking opioids in the past three years did so  to manage short-term (acute) pain (43%) or for other types of pain (36%), such as a surgical or dental procedure. Still, a significant number of patients – more than 1 in 4 (28%) – take them to relieve chronic pain.

Experience with Alternative Treatments
Recognizing the potential for abuse or addiction, nearly all patients (92%) who have used opioids in the past three years have tried alternative pain approaches, including over-the-counter medication (81%), topical prescriptions (36%), and alternative medicine (25%), such as acupuncture and herbal remedies. However, only 1 in 4 (24%) report any of these options was effective.

Side Effects and Safe Storage:  Gaps in Patient-Physician Communication
While the majority of HCPs and patients who took prescription opioids in the past three years do discuss proper usage of opioids and their side effects,  gaps exist between physicians' self-reported rates of discussion and the rates at which patients say they receive information:

  • Patients and professionals say they have discussed "how and when to take the medication" (92%, respectively)
  • A substantially higher number of HCPs report discussing the following topics, compared to the number of patients who report receiving that information – highlighting a disconnect between what HCPs believe they are sharing with patients and what patients report receiving:
    • Side effects (93% of HCPs vs. 81% of patients)
    • Risks/concerns about abuse and addiction (80% vs. 71%)
    • Not sharing the medications (70% vs. 62%)
  • Further, only about half of both HCPs (55%) and patients (57%) report discussing safe storage and disposal of the medications, which are lower proportions than their discussions about risks and how to use the medications

Importantly, while more than 4 in 10 patients think that other patients are misusing or abusing opioids, there seems to be a disconnect between overall perceived risks and the possibility of personal involvement. For example, while only 2% of patients claimed to do any sharing of their own prescribed opioids, 42% believe opioid sharing is occurring. 

Abuse and Misuse:  HCP Concerns
HCPs are nearly unanimous in their concern about opioid misuse (99% concerned). Patients report a lower level of concern than HCPs on some of the the following topics:   

  • Abuse (purposeful use other than as prescribed): 52% of HCPs vs. 46% of patients
  • Addiction: 54% of HCPs vs. 6% of patients
  • Sharing prescriptions: 55% of HCPs vs. 42% of patients
  • Prescription medications falling into the wrong hands: 36% of HCPs vs. 36% of patients
  • Leading to the use of stronger drugs, such as morphine or heroin: 38% of HCPs vs. 38% of patients

HCPs also express concerns about how patients use opioids, with the majority believing that patients "frequently" take more than prescribed (66%) and/or take the medication for purposes other than those prescribed (52%). A sizeable proportion of HCPs (38%) also believe that backlash against opioid analgesic prescribing – and increased regulation around these medications – has diverted abusers to stronger compounds such as morphine and heroin.

The Dangers of a National "Public Inventory"
Of those patients who have taken an opioid in the past three years, more than 4 in 10 (42%) say they store the leftovers for future use, contributing to a large "public inventory." With more than 100 million opioid prescriptions written during the past 20 years, this practice translates into a large number of unused opioids in the nation's medicine cabinet – presenting a greater opportunity for misuse and abuse by anyone for whom the drugs were not prescribed.  Only 23% of patients report returning unused opioids to pharmacies that offer disposal programs.

Quote
Michael W. Smith, MD, MBA, Medical Director and Chief Medical Editor, WebMD

  • "With opioid prescriptions and overdose-related deaths affecting Americans at alarming rates, understanding patient and physician perceptions of risk and appropriate use play an important role in helping to reduce misuse, addiction and diversion. Healthcare professionals need to revisit their approach to discussing addiction risks and proper storage and disposal with patients to ensure guidance is clear; similarly, patients need to be aware of all of the potential risks associated with these powerful drugs, including abuse, addiction, and having the drugs fall into the wrong hands."

About the WebMD Opioids Use and Addiction Survey (Patient Audience)
WebMD's Opioids Use and Addiction Survey was completed by 1,887 random U.S. desktop and mobile WebMD site visitors from November 18 - 25, 2015.  The sample represents the WebMD.com online population with a margin of error of ± 2.25% at a 95% confidence level, using a point estimate (a statistic) of 50%, given a binomial distribution. The subsample size for those who used a prescription opioid in the past 3 years is 659.

About the Medscape Opioids Use and Addiction Survey (Professional Audience)
Medscape's Opioids Use and Addiction Survey was completed by 1,513 U.S. clinicians who are currently active on Medscape. The largest group of respondents was physicians (n=832), followed by nurse practitioners (491) and physician assistants (190). The survey was fielded November 20 to December 8, 2015, via email invitation. The sample represents active Medscape clinicians at the 95% confidence interval with a margin of error of ± 2.52%, using a point estimate (a statistic) of 50%, given a binomial distribution.

Three physician specialties (nephrology, pathology, and radiology) were not included because they do not tend to prescribe opioids. All physician assistant and nurse practitioner specialties were sampled. A minimum quota of 50 respondents was set for the following five physician specialties due to their higher likelihood to prescribe opioids, with the following results:  anesthesiology (n=98), emergency medicine (n=109), general practice/internal medicine/family practice/primary care (n=77), neurology (n=70), and psychiatry (n=115). Surgeons (general, plastic, orthopedic, and neuro-), while not given a minimum quota, were sampled fairly heavily, again due to higher likelihood to prescribe opioids (n=60).

About Medscape and WebMD
Medscape is the leading source of clinical news, health information and point-of-care tools for healthcare professionals. Medscape offers specialists, primary care physicians and other health professionals the most robust and integrated medical information and educational tools. Medscape Education (medscape.org) is the leading destination for continuous professional development, consisting of more than 30 specialty focused destinations offering thousands of free C.M.E. and C.E. courses and other educational programs for physicians, nurses and other healthcare professionals.

WebMD Health Corp. (NASDAQ: WBMD) is the leading provider of health information services, serving consumers, physicians, healthcare professionals, employers, and health plans through our public and private online portals, mobile platforms and health-focused publications.

The WebMD Health Network includes WebMD Health, Medscape, MedicineNet, eMedicineHealth, RxList, Medscape Education and other owned WebMD sites.

WebMD®, Medscape®, CME Circle®, Medpulse®, eMedicine®, MedicineNet®, theheart.org® and RxList® are among the trademarks of WebMD Health Corp. or its subsidiaries.

 

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SOURCE WebMD



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