Surgical patients' fear of addiction to pain medication: the effect of an educational program for clinicians.

OBJECTIVE The appropriate and optimal use of analgesics is essential for the adequate management of postoperative pain. Concern that use of opioid analgesics contributes to the development of addiction is a barrier to effective pain relief. The purpose of this study was to determine the prevalence of fear of addiction in postoperative patients in relation to surgical outcomes and staff participation in an educational program. DESIGN Two treatment levels (program vs. control) and three data collection periods (before program, immediately after the program, and 6 months after the program). SETTING Six community hospitals with 100-500-bed capacities in a southeastern state. PATIENTS Seven hundred eighty-seven patients who had undergone orthopedic or laparotomy procedures. INTERVENTIONS Staff at three of the six hospitals received an educational program to promote implementation of Agency for Health Care Policy and Research acute pain management guidelines. OUTCOME MEASURES Patient report of preoperative and postoperative fear of addiction, satisfaction with pain treatment, communication with clinicians, and pain intensity. RESULTS Only 10.8% of the sample reported preoperative or postoperative fear of addiction. Staff participation in the educational program was found to decrease fear of addiction in this sample. Fear of addiction was also related to surgery type, with disc surgery patients more likely to report fear of addiction as compared with patients undergoing other types of surgery. Fear of addiction was not related to other outcomes in this sample. CONCLUSIONS Fear of addiction is not prevalent among postoperative patients, yet clinician education can further decrease the proportion of surgical patients who fear of addiction to pain medication.