As a result of the pharmaceuticalization of chronic pain over the past three decades, opioid therapy became a common form of treatment for chronic pain patients. However, the overprescribing of opioids led to the opioid overdose epidemic in the United States. In response, the Centers for Disease Control and Prevention implemented guidelines reducing the number of opioid prescriptions—better known as opioid pharmacovigilance. Little is known about the sociocultural challenges during the transition to opioid pharmacovigilance for the resident/patient relationship. Using a thematic analysis, we analyzed 20 semi-structured interviews of residents and chronic non-cancer pain (CNCP) patients in a family medicine residency practice. Findings suggest that due to the pharmaceuticalization of CNCP and the transition to opioid pharmacovigilance, residents develop a wariness to prescribe opioids, which leads to prejudice against patients. Patients report constrained care and a lack of alternative treatments for chronic pain, which inevitably leads to duplicitous behavior.

由于过去三十年慢性疼痛的药物化，阿片类药物治疗成为慢性疼痛患者的常见治疗方式。然而，阿片类药物的过量处方导致了美国阿片类药物过量流行。作为回应，疾病控制和预防中心实施了减少阿片类药物处方数量的指南——更广为人知的阿片类药物警戒。对于住院医师/患者关系向阿片类药物警戒过渡期间的社会文化挑战知之甚少。使用主题分析，我们分析了在家庭医学住院医师实践中对住院医师和慢性非癌痛 (CNCP) 患者进行的 20 次半结构化访谈。研究结果表明，由于 CNCP 的药物化和向阿片类药物警戒的过渡，居民对开阿片类药物持谨慎态度，从而导致对患者的偏见。患者报告说护理受限并且缺乏针对慢性疼痛的替代疗法，这不可避免地导致了两面派行为。