Should Chronic Pain Care Providers Be Worried About Violent Patients?

Healthcare professionals who specialize in chronic pain care could be opening themselves up to potential violence, a safety concern for anyone dealing with these patients on a daily basis.

Published in Pain Medicine, a report concluded that 64.85% of chronic pain care providers (CPCPs) have called security and 51.52% have received threats.¹ A little more than 7% of these threats involved a firearm. Survey attendees reported injury 2.73% of the time.

Researchers conducted an e-mail survey of members of the American Society of Interventional Pain Physicians, a non-profit that represents interventional pain specialists, to learn more about violence rates against CPCPS; character, context and risk factors for violence; and mitigation strategies.

Study author Dr. David D. Kim, a pain medicine specialist from the Henry Ford Hospital in Detroit, told Clinical Pain Advisor in an interview that physicians who specialize in pain are high risk targets for violence because they are “more likely to be referred patient who are addicted or at least dependent on opioids that there primary care doctors started them on and suddenly don’t feel comfortable dealing with.”

Additionally, researchers found that the highest context for violence involved the area of opioid management (89.9%).

“Opioids we know can alter brain function and addiction itself can cause loss of self control,” he said. “Pain physicians are the end of the line for patients who have been treated by multiple other specialties especially spine surgeons who have done multiple surgeries with worsening outcomes who may feel very frustrated or angry.”

He added: “With chronic pain itself, a patient may have either preexisting or post chronic psychosocial which may cause lack of control of behavior. The fact that the highest risk is with opioid management and disability bears this out.”