New study shows that doctors are hesitant to take patients with opioid use disorder.
A new study out of Canada suggests that family doctors are three times less likely to get a new patient in if they are suffering with opioid use disorder (OUD) than if they are struggling with a heart related issue or diabetes. In a randomized clinical trial that included almost 400 family physicians, those with more than 20 years’ experience were almost 13 times less likely to offer an appointment to a patient with OUD than to a patient with diabetes. Opioid use disorder is a serious medical condition that is typified by a problematic pattern of opioid use. This can include using opioids excessively, using them in ways that are harmful, and having difficulty quitting use.
It’s no secret that the opioid epidemic is sweeping the nation and Canada. The world, actually, continues to struggle with it. In the U.S., more than 2 million residents suffer from opioid addiction, and over 33,000 people die from opioid overdoses every year.
While OUD is a serious condition, it is treatable – researchers just weren’t aware of how little it was being treated in Canada or that it was being surpassed by the treatment of other health conditions according to priority. The study was published September 30 in JAMA Network Open.
“We knew from previous work that we had done here in Ontario, and that people have done in other places, that people with addictions, in particular addictions to opioids, are less likely to have a family doctor or primary care provider,” study author Sheryl Spithoff, MD, MSc, assistant professor of family and community medicine at the University of Toronto, Canada, said. “People have given different explanations as to why this may be the case, and we wondered if family doctor discretion in accepting and taking on new patients was playing a role.”
To carry out the study, investigators utilized an audit design to examine new patient intake paperwork at the offices of randomly selected family doctors or internal medicine physicians. “Eligible physicians were able to prescribe opioids and practiced within 50 km (31 miles) of a city of more than 20,000 people,” the study states.
The doctor participants, nearly 400, were contacted by an actor pretending to be a patient. Of the actors, 185 claimed to have diabetes and to already be seeing an endocrinologist. On calls with the other nearly 200 physicians, the actor said to have “OUD, to be receiving methadone treatment, and to have an addiction physician.”
The study found that “21 of 185 physicians (11.4%) offered a new patient appointment to a caller with diabetes, and 8 of 198 (4%) offered an appointment to a caller in treatment for OUD.”
With doctors twenty years into practice, 1 of 108 (0.9%) offered an appointment to a caller with OUD, and 10 of 84 physicians (11.9%) offered an appointment to a caller with diabetes.”
Spithoff did know why female family care doctors were more likely to not accept a patient with OUD in their practice, but she thought that it may be that young physicians who are early in their career have received enough education about OUDs and how to manage the disorder.