Physicians' attitudes toward pain and the use of opioid analgesics: Results of a survey from the Texas cancer pain initiative

Background. Despite extensive progress in the scientific understanding of p ain in humans, serious mismanagement and undermedication in treating acute and chronic pain is a continuing problem. This study was designed to examin e the barriers to adequate pain management, especially as they might be ass ociated with community size and medical discipline. Methods. A 59-item survey was used to measure physicians' attitudes, knowle dge, and psychologic factors that contribute to pain management practices. Results. Overall, a significant number of physicians in this survey reveale d opiophobia (prejudice against the use of opioid analgesics), displayed la ck of knowledge about pain and its treatment, and had negative views about patients with chronic pain. There were significant differences among groups of physicians based on size of geographic practice area and medical discip line. Conclusions. New educational strategies are needed to overcome these barrie rs and to improve pain treatment in routine medical practice. The effect of practice milieu must be taken into consideration.