Medical students' attitudes toward pain and the use of opioid analgesics: implications for changing medical school curriculum
Weinstein SM, Laux LF, Thornby JI, Lorimor RJ,
Hill CS Jr, Thorpe DM, Merrill JM
Department of Neuro-Oncology,
University of Texas M.D.
Anderson Cancer Center,
Houston, USA.
South Med J 2000 May; 93(5):472-8


BACKGROUND: Barriers to pain management include physicians' lack of knowledge and attitudes. Our aim was to investigate future physicians' knowledge and attitudes toward pain and the use of opioid analgesics. METHODS: We tested a medical school class during their freshman and senior years. Stepwise regression analysis was used to identify the personal traits that predicted opiophobia. RESULTS: The professionalization process of medical training may reinforce negative attitudes. Psychologic characteristics were associated with reluctance to prescribe opioids, and fears of patient addiction and drug regulatory agency sanctions. CONCLUSIONS: Consistent attitudes were found in senior medical students with preferences for certain specialty areas and the practitioners of their future specialties, suggesting a "preselection" effect. Higher scores on reliance on high technology, external locus of control, and intolerance of clinical uncertainty were associated with higher scores on one or more of the three dimensions of opiophobia. Implications for medical education are discussed.
Fetal pain
Opium timeline
Opioid receptors
NMDA anatagonists
Spinal opioid therapy
Endomorphins 1 and 2
Congenital anaesthesia
Next-generation painkillers?
The Pain Survival Guide (pdf)
A history of pain-management
Suffering and the price Of pain
Pain and analgesia: mechanisms
Pain therapy: why voodoo works
Nociception, pain and antinociception
Prescribing opioids for the management of chronic pain

and further reading

Future Opioids
BLTC Research
Utopian Surgery?
The Abolitionist Project
The Hedonistic Imperative
The Reproductive Revolution
Critique of Huxley's Brave New World

The Good Drug Guide
The Good Drug Guide

The Responsible Parent's Guide
To Healthy Mood Boosters For All The Family