Managing Multiple Goals in Opioid Prescription Communication
Perspectives from Trauma Physicians release_y2mhdiq5ajb53n6dggm4ocpv5u

Abstract

Prescription opioids and heroin account for more than half of all drug overdose fatalities, claiming an estimated 91 American lives every day (Rudd, Seth, David, & Scholl, 2016). The ongoing opioid epidemic represents a tremendous burden to the national economy and healthcare system (Rudd, Aleshire, Zibbell, & Gladden, 2016). In 2016, the Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy proposed action to train prescribers on the proper dispensing of opioids, which are indispensable pharmacologic resources for treating acute pain resulting from trauma or surgery. This study examines the prescribing practices of trauma surgeons who enter patient consultations with multiple competing goals respective to their roles as a healers of the suffering, regulators of illicit substances, members of a larger medical system working to contain an opioid epidemic, and moral beings with a distinct set of experiences and practice philosophies. Semi-structured interviews with 17 trauma and surgical residents and fellows at a southeastern medical center generated descriptive data regarding prescribing practices and patient communication. Guided by the multiple goals framework, the study produced three themes depicting the intersection and entanglement of identity, task, and relational goals during opioid-prescribing conversations between trauma surgeons and their patients.
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