Potential Consequences of Opioid-Related Stigma for Individuals With Chronic Pain

Opioid-related stigma involves negative thoughts and beliefs about treatment with opioid pain medications. Individuals with chronic pain who are treated with opioid therapy may face opioid-related stigma from health care professionals, family members or friends, or even themselves. For example, health care professionals may be reluctant or unwilling to prescribe opioids even in cases of severe pain; friends, family or coworkers may judge the individual for taking opioids to treat their chronic pain; and the individuals themselves may begin to fear their medication or experience emotional distress due to opioid-related stigma.

Barriers to treatment

The most dire consequence of opioid-related stigma involves barriers to treatment. Opioid-related stigma can prevent individuals with chronic pain from seeking or receiving adequate treatment. Physicians affected by opioid-related stigma may be leery of prescribing opioids due to potential legal issues or the loss of their medical license if opioid misuse occurs. They may refer the individual to another physician or abandon the doctor-patient relationship completely. Even when an opioid is prescribed, regulations from insurance companies and governmental organizations can make it difficult or even impossible to fill the prescription. If an opioid prescription can be filled, individuals may be afraid to take it due to the fear of developing an opioid use disorder.

Barriers to treatment and the resulting lack of adequate pain relief due to opioid-related stigma can have serious consequences. Examples include the following:

• If an individual breaks a rib and can’t breathe normally or cough without severe pain, opioid pain medications can help relieve the pain so pneumonia or other complications are less likely to develop.
• Suicidal thoughts or behaviors may develop if severe pain is dismissed or untreated.
• If an individual has been taking opioids on a regular basis and is suddenly denied access to them due to changes in regulations, withdrawal or even death can occur.

Mental health concerns

Opioid-related stigma can also affect the mental health of individuals with chronic pain who require opioid therapy. They may feel guilt, shame or judgment about their opioid treatment. These feelings can actually worsen chronic pain. Opioid-related stigma can also produce significant mental health consequences, such as anxiety, depression, or suicidal thoughts or behaviors.

The consequences of opioid-related stigma can be reduced or eliminated with proper education regarding chronic pain and opioids. This will help ensure that individuals with chronic pain are able to access adequate pain relief.

Additional sources used to create this article include the U.S. Department of Human and Health Services, Nurse.com, and the U.S. Department of Human and Health Services.