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      Morphinofobia: the situation among the general population and health care professionals in North-Eastern Portugal

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          Abstract

          Background

          Morphinofobia among the general population (GP) and among health care professionals (HP) is not without danger for the patients: it may lead to the inappropriate management of debilitating pain. The aim of our study was to explore among GP and HP the representation and attitudes concerning the use of morphine in health care.

          Methods

          A cross-sectional study was done among 412 HP (physicians and nurses) of the 4 hospitals and 10 community health centers of Beira Interior (Portugal)and among 193 persons of the GP randomly selected in public places. Opinions were collected through a translated self-administered questionnaire.

          Results

          A significant difference of opinion exists among GP and HP about the use of morphine. The word morphine first suggests drug to GP (36,2%) and analgesia to HP (32,9%.). The reasons for not using morphine most frequently cited are: for GP morphine use means advanced disease (56%), risk of addiction (50%), legal requirements (49,7%); for HP it means legal risks (56,3%) and adverse side effects of morphine such as somnolence - sedation (30,5%) The socio-demographic situation was correlated with the opinions about the use of morphine.

          Conclusions

          False beliefs about the use of morphine exist among the studied groups. There seems to be a need for developing information campaigns on pain management and the use of morphine targeting. Better training and more information of HP might also be needed.

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          Most cited references 38

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          Opioid therapy for chronic pain.

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            Morphine and alternative opioids in cancer pain: the EAPC recommendations

             G Hanks,  F Conno,  N Cherny (2001)
            An expert working group of the European Association for Palliative Care has revised and updated its guidelines on the use of morphine in the management of cancer pain. The revised recommendations presented here give guidance on the use of morphine and the alternative strong opioid analgesics which have been introduced in many parts of the world in recent years. Practical strategies for dealing with difficult situations are described presenting a consensus view where supporting evidence is lacking. The strength of the evidence on which each recommendation is based is indicated. © 2001 Cancer Research Campaign
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              Predicting opioid misuse by chronic pain patients: a systematic review and literature synthesis.

              Opioids can provide relief for people with chronic pain. However, a minority may develop aberrant drug behaviors. A critical issue is identifying "at-risk" patients. To synthesize the evidence of published strategies for identifying at-risk patients to guide clinicians' decisions and practices for prescribing opioid treatment for chronic pain patients (CPP). MEDLINE database search from 1966 to March 20, 2007, searching the bibliographies from all retrieved articles, and articles available in the authors' files. Studies were limited to human studies in the English language related to screening for predictors of aberrant drug behaviors in CPP who were prescribed long-term opioids. We included studies reviewing, developing measures, or investigating outcomes related to screening for aberrant opioid behaviors in CPP. We identified 6 published articles addressing clinician-based predictors of substance misuse of opioids and 9 published studies evaluating the predictive ability of clinical interviews and self-report measures for aberrant opioid behaviors in CPP. Several attempts have been made to develop procedures to identify at-risk patients including urine toxicology screening, structured interviews, observation, and self-report questionnaires. In general, the psychometric properties of the published questionnaires and interview protocols are weak; moreover, the samples included in the studies are often small and unrepresentative. Thus, none of them can be recommended for use with any confidence. Review of the published studies reveals that no one procedure or set of predictor variables is sufficient to identify CPP at-risk for opioid misuse or abuse. There is a scarcity of evidence regarding characteristics that predict aberrant behavior before beginning long-term opioids. Several predictors have been identified. Strong predictors include a personal history of illicit drug and alcohol abuse. Demographic factors have also been reported, but the results are not consistent. Prospective studies, especially ones with CPP who have not already been started on chronic opioid therapy, are needed.
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                Author and article information

                Journal
                BMC Palliat Care
                BMC Palliative Care
                BioMed Central
                1472-684X
                2010
                22 June 2010
                : 9
                : 15
                Affiliations
                [1 ]Geneva Altitude Clinic, Montana, Switzerland
                [2 ]Department of Community health and medicine, Faculty of medicine, University of Geneva, Geneva, Switzerland
                [3 ]Formerly RN in the hospital Castèlo Branco, Beira Interior, Portugal and responsible of chirurgical ward hospital of Siders, RSV, Switzerland
                [4 ]Faculty of Medicine, University of Geneva, Geneva, Switzerland
                [5 ]Faculty of medicine, University of Geneva, Geneva, Switzerland and Director of the Department Age, Health and Society, University Institute Kurt Bösch, Sion, Switzerland
                Article
                1472-684X-9-15
                10.1186/1472-684X-9-15
                2900233
                20569454
                Copyright ©2010 Verloo et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research article

                Anesthesiology & Pain management

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