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Improving pain management communication: how patients understand the terms "opioid" and "narcotic"

Mangione MP, Crowley-Matoka M. Improving pain management communication: how patients understand the terms "opioid" and "narcotic". Journal of general internal medicine. 2008 Sep 1; 23(9):1336-8.

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BACKGROUND/OBJECTIVES: Pain specialists often advocate discontinuing use of the term "narcotic," with the negative connotations it bears for many patients, in favor of the term "opioid." To contribute empirical data to this argument, we elicited and compared patient understandings of the terms "narcotic" and "opioid." DESIGN/PARTICIPANTS: Brief, anonymous surveys were administered to 100 outpatients. Respondents were asked to describe what a narcotic/opioid is, give example(s), explain why someone would take a narcotic/opioid and describe long term consequences of use. RESULTS: Of the 100 outpatients, 86% responded "don''t know" to all four opioid questions. Only 12% did not know what a narcotic was (p < 001). While 50% of patients related "narcotics" to pain management, more than a third cited addiction or abuse. Of the 100 outpatients, 78% feared an adverse outcome from long-term narcotic use, with 66% of those answers citing "addiction." CONCLUSION: Most patients were unfamiliar with the term opioid, while a substantial percentage identified a narcotic as an illegal drug and most reported adverse consequences as the outcome of long term use. Our findings, while preliminary, suggest that "opioid" is a more unfamiliar term, but raise questions about whether simply using different terminology would affect patient fears about this class of medications.

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