Medical students' attitudes toward pain and the use of opioid analgesics: Implications for changing medical school curriculum

Background. Barriers to pain management include physicians' lack of knowled ge and attitudes. Our aim was to investigate future physicians' knowledge a nd attitudes toward pain and the use of opioid analgesics. Methods. We tested a medical school class during their freshman and senior years. Stepwise regression analysis was used to identify the personal trait s that predicted opiophobia. Results. The professionalization process of medical training may reinforce negative attitudes, Psychologic characteristics were associated with reluct ance to prescribe opioids, and fears of patient addiction and drug regulato ry agency sanctions. Conclusions. Consistent attitudes were found in senior medical students wit h preferences for certain specialty areas and the practitioners of their fu ture specialties, suggesting a "preselection" effect. Higher scores on reli ance on high technology, external locus of control, and intolerance of clin ical uncertainty were associated with higher scores on one or more of the:t hree dimensions of opiophobia. Implications for medical education are discu ssed.