Results
Fifty surveys were collected from 101 attendees, a response rate of 49.5%. The qualitative results of the CME analysis are illustrated in Figure 2.
Provider-Centric Responses
Approximately 55% of the responses were health care provider-centric. The research team categorized these responses according to the following topics: stigma/bias toward individuals with SUDs, prescribing concerns, provider protection, resistance and denial, and communication and collaboration.
Stigma and Bias Toward Individuals With SUDs. Twenty-two percent of participants’ freetext responses suggested stigma and/or bias. Responses in this category included stigmatizing language, described patients being treated as criminals or as “less than” others, speculated about perceived patient intentions, and/or discussed the possibility that stigma and biases contribute to inadequate allocation of SUD resources.
“Many pharmacists and doctors refer to patients as drug seekers and junkies.”
“I think many health care providers have bias against those with opioid use disorders; we are taught to watch out for drug-seeking behaviors.”
“Out of fear for the professional’s licenses, these patients probably do not get the same level of attention as nonaddicted patients receive.”
Prescribing Concerns. Concerns about prescribing treatment to patients who have OUDs were reported by 17% of respondents. Respondents also noted their interests in implementing harm reduction strategies, being able to monitor patients closely, and receiving more guidance through guidelines or protocols.
“Public programs are not providing necessary counseling and treatment access.”
“These patients often don’t benefit from jail/prison and more often need treatment programs.”
“I think that naloxone protocols and education of both patients and providers, as well as patient’s family and friends, is a good place to start.”
Figure 2. Qualitative Results of CME Analysis 
Provider Protection. A small number of respondents (7%) registered worries about risking their licenses to treat patients with OUDs. Providers expressed concern about the consequences that could arise from a situation in which the naloxone prescribed or dispensed did not save someone’s life. They reported being worried about the liability associated with dispensing a medication that could potentially have a poor outcome.
“I am not concerned with following protocols and doing everything right. I am also not concerned with a judgment during the ensuing civil suit. I am worried about who does my job and takes care of my family while I spend the next 3 years in court fighting with a deceased narcotic abuser’s survivors. It isn’t worth doing. We do not provide life support services, we do not have staffing and support for this; they need an emergency department for supportive care.”
“Most of the patients that I dispense opioids to would prefer to be high all the time. They would have no desire to come down from that high. They would then blame the pharmacist or physician if something untoward would ever happen to them.”
Resistance and Denial. A small number of respondents (7%) reported resistance to treating patients with OUDs or denied that an opioid crisis currently exists.
Communication and Collaboration. One health care provider’s response suggested that increasing communication and collaboration between health care providers’ practices would benefit patient care.
Patient-Centric Responses. Approximately 29% of free-text responses included patientcentric perceptions. The research team categorized these responses according to the following topics: discrimination, treatment availability, fear and shame, and provider and patient education.
Discrimination. A cohort of providers (11%) suggested that patients with OUDs are discriminated against by the health care community
Treatment Availability. A small number of providers (7%) identified a need for more treatment availability in treatment centers and alternative treatments or taper regimens.
Fear and Shame. Seven percent of respondents observed that patients living with OUDs face fear and/or shame in their everyday life.
“The way that people are treated by nurses and law enforcement make it harder for them to get help, treatment, mental health care.”
“They are stigmatized as dirty, bad people, manipulative people.”
“Stereotypes and stigmas get in the way of seeing the patient and hearing their concerns.”
Provider and Patient Education. Respondents reported that both provider and patient education should address the opioid crisis. When respondents were asked whether they believed that patients with OUDs are living with a medical condition or have criminal tendencies, 60% reported that OUD is solely a medical condition, 20% reported that it is a medical condition with related criminal concerns, and 20% reported that it is equally a medical condition and a criminal situation.
While the qualitative results of this study provided the most insight into health care professionals’ perceptions of the causes and consequences of the opioid crisis, the quantitative results are also startling. For example, nearly 75% of respondents believe individuals with opioid use disorder are discriminated against by the medical community. Additionally, roughly 16% of respondents do not believe that stigma and bias contribute to the opioid crisis. See Table 1 for the full responses.