Pharmaceuticalization to Opioid Pharmacovigilance: A Qualitative Investigation of the Impact of Opioid-related Policy Changes and the Perspectives of Residents and Chronic Non-cancer Pain Patients

Abstract

As a result of the pharmaceuticalization of chronic pain over the past three decades, opioid therapy became a common form of treatment for chronic pain patients. However, the overprescribing of opioids led to the opioid overdose epidemic in the United States. In response, the Centers for Disease Control and Prevention implemented guidelines reducing the number of opioid prescriptions—better known as opioid pharmacovigilance. Little is known about the sociocultural challenges during the transition to opioid pharmacovigilance for the resident/patient relationship. Using a thematic analysis, we analyzed 20 semi-structured interviews of residents and chronic non-cancer pain (CNCP) patients in a family medicine residency practice. Findings suggest that due to the pharmaceuticalization of CNCP and the transition to opioid pharmacovigilance, residents develop a wariness to prescribe opioids, which leads to prejudice against patients. Patients report constrained care and a lack of alternative treatments for chronic pain, which inevitably leads to duplicitous behavior.