Treah Haggerty, MD, MS; Cara L. Sedney, MD, MA; Patricia Dekeseredy, RN, MScN; Divine Nwafor, BS; Henry H. Brownstein, PhD; Martina A. Caretta, PhD; Robin A. Pollini, PhD, MPH
Corresponding Author: Treah Haggerty, MD, MS; West Virginia University Department of Family Medicine.
Contact Email: haggertyt@hsc.wvu.edu
Section: Original Research
PURPOSE: Opioid use disorder has caused significant morbidity and mortality resulting in opioid prescribing limiting laws, such as state bill 273 in West Virginia. The purpose of this study is to explore the impacts of a restrictive opioid prescription law on physicians in medical practice in West Virginia.
METHODS: A qualitative study with open-ended semi-structured interviews with a purposive sample of physicians in West Virginia. Interviews were recorded and transcribed verbatim. A preliminary code book was developed by three coinvestigators. Interview transcriptions were analyzed with a code-based text search query. Content analysis was utilized as the methodological orientation underpinning for the current work.
RESULTS: Interviews were conducted with 20 physicians (10 primary care physicians and 10 specialty physicians) in practice in West Virginia. Physicians identified five theoretical domains related to SB273: changing opioid prescribing and documentation requirements; rural socioeconomic disparities; a continuum between chronic pain and substance use disorder; difficulty in balancing patient needs and the concern for diversion; lack of available alternatives to opioids for chronic.
CONCLUSION: Prescribing opioids in rural West Virginia is complex due to identified challenges. Recommendations for opioids prescribing legislation include clear messaging of guidelines and recommendations, efforts to address socioeconomic disparities of health and pain, and improved accessibility for treatment of both pain and dependence in rural communities are important areas of growth in the rural healthcare environment.