Investigating the Opioid Epidemic: How Patient Perceptions, Diagnoses and Access to Treatment Shape Prescription Opioid Use in Rural Appalachia

     Opioid analgesics (painkillers) are extremely effective and commonly prescribed medications for pain management but, as mu-opioid agonists, they also have high abuse liability and are able to induce rapid... [ view full abstract ]

     Opioid analgesics (painkillers) are extremely effective and commonly prescribed medications for pain management but, as mu-opioid agonists, they also have high abuse liability and are able to induce rapid neurobiological tolerance. These factors, in combination with ease of access and perceived safety, can contribute to escalating drug use and increased risk for addiction. Given that pain is one of the most common medical diagnoses in medicine (for chronic noncancer pain, 4%-40% of diagnoses in primary care settings; Volkow & McLellan 2011), this project investigates opiate use amongst chronic pain patients in rural Southern Appalachia. Early evidence suggests that, within the local community, factors contributing to opiate use involve a combination of complex neurobiological, psychosocial, and logistical considerations. Via informal interviews with local healthcare providers, we are identifying barriers to non-pharmaceutical treatment options for patients with acute and chronic pain. For instance, lack of complementary and alternative medicine options may contribute to an overreliance upon opioid analgesics. It is also unclear how patients perceive the efficacy of non-pharmaceutical pain treatments, and whether they are willing to try them. Minimizing and/or limiting opioid use in contexts when it may not be medically necessary may reduce patients’ risk for developing dependence and/or opioid use disorder, and may thus help alleviate aspects of the opioid epidemic in our local community. This presentation will review current literature, summarize information gathered via informal interviews, and present the design for a pilot study developed to investigate patients’ perceptions and attitudes related to opioid use and pain management.