People who take opioids for pain can’t get in the door at half of primary care clinics

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In a new study, researchers found that people who take opioid medications for chronic pain may have a hard time finding a new primary care clinic that will take them on as a patient if they need one.

They found stigma against long-term users of prescription opioids, likely related to the prospect of taking on a patient who might have an opioid use disorder or addiction, appears to play a role.

The research was conducted by a team at the University of Michigan.

In the study, the team checked 452 clinics in nine states across the country.

Each clinic responded to two calls, separated by time, from a female caller who asked if the clinic was taking new patients, said she was covered by a major insurer in the area, and said she had been taking opioids for years for pain.

Depending on the call, she then either said that her last provider had retired or stopped prescribing opioids, leading her to seek a new primary care clinic and asking if their providers would potentially continue to prescribe opioids after a visit.

The team found all of the clinics said they were taking new patients, but when the patient mentioned wanting to receive opioids, 43% of the clinics said they were no longer willing to schedule the appointment.

Nearly one-third (32%) of the clinics said they would schedule the patient for an appointment and the primary care provider would potentially continue to prescribe opioids, no matter which scenario the patient gave.

But the remaining 25% of clinics gave mixed signals when called twice.

In those clinics, patients had nearly 2 times the likelihood of getting scheduled if their prior physician had retired as compared to those who said their last doctor had stopped prescribing for unknown reasons.

This suggests that many clinics are likely just shutting their door to any patient needing an opioid prescription despite the reason for needing a new provider.

The team says that it is hard to treat opioid addiction in a primary care setting, because of the special training needed to prescribe buprenorphine and the added support needed to help patients receiving medications for opioid use disorder.

Recent signs that the federal requirements may be relaxed could help change this, but only if primary care providers receive help and training in providing this kind of care.

The team hopes the new findings could help primary care clinics look at their practices regarding existing or prospective new patients.

One author of the study is Pooja Lagisetty, M.D., M.Sc.

The study is published in Pain.

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