Exploring perspectives on changing opioid prescribing practices: A qualitative study of community stakeholders in the HEALing Communities Study

Daniel M. Walker, Janet E. Childerhose, Sadie Chen, Nicolette Coovert, Rebecca D. Jackson, Natasha Kurien, Ann Scheck McAlearney, Jaclyn Volney, Daniel P. Alford, Julie Bosak, Douglas R. Oyler, Laura K. Stinson, Melika Behrooz, Mia Cara Christopher, Mari Lynn Drainoni

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Community-based perspectives are needed to more broadly inform policy-makers, public health practitioners, prescribers, and pharmacists about community-led and broader efforts to reduce opioid overprescribing, and ultimately reduce prescription opioid use disorder, overdoses and fatalities. The aim of this study is to explore community-based perspectives on efforts to change opioid prescribing practices in their communities. Methods: Semi-structured interviews were conducted with 388 community stakeholders across four states (Kentucky, Massachusetts, New York, Ohio) from November 2019 to January 2020 about community approaches and goals of community-led responses to the opioid crisis. Data analysis combined deductive and inductive approaches to identify themes and sub-themes related to improving opioid prescribing practices. Results: Three major themes and different subthemes were characterized: (1) acknowledging progress (i.e., healthcare providers being part of the solution, provider education, and prescription drug monitoring programs); (2) emergent challenges (i.e., physician nonadherence with safer opioid prescribing guidelines, difficulty identifying appropriate use of opioids, and concerns about accelerating the progression from opioid misuse to drug abuse); and (3) opportunities for change (i.e., educating patients about safer use and proper disposal of opioids, expanding prescriber and pharmacist education, changing unrealistic expectations around eliminating pain, expanding and increasing insurance coverage for alternative treatment options). Conclusions: Community stakeholders appeared to support specific opportunities to reduce prescription opioid misuse and improve safer prescribing. The opportunities included culture change around pain expectations, awareness of safe disposal, additional provider education, and increased coverage and acceptability of non-opioid treatments.

Original languageEnglish
Article number109342
JournalDrug and Alcohol Dependence
Volume233
DOIs
StatePublished - Apr 1 2022

Bibliographical note

Funding Information:
This research was supported by the National Institutes of Health (NIH) and the Substance Abuse and Mental Health Services Administration through the NIH HEAL (Helping to End Addiction Long-term SM ) Initiative under award numbers UM1DA049394 , UM1DA049406 , UM1DA049412 , UM1DA049415 , UM1DA049417 (ClinicalTrials.gov Identifier: NCT04111939 ). This study protocol (Pro00038088) was approved by Advarra Inc., the HEALing Communities Study single Institutional Review Board. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health, the Substance Abuse and Mental Health Services Administration or the NIH HEAL Initiative SM .

Publisher Copyright:
© 2022 Elsevier B.V.

Keywords

  • Community
  • HEALing Communities Study
  • Opioid prescribing
  • Qualitative
  • Safer prescribing

ASJC Scopus subject areas

  • Toxicology
  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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