Opioid knowledge and concerns: Challenges among physicians in Turkey.

Abstract

e13541 Background: The global opioid crisis highlights misuse risks, while Türkiye struggles with prescribing opioids due to knowledge gaps, biases, and insufficient training, impeding effective pain management for cancer patients and necessitating evidence-based interventions. Methods: This cross-sectional survey, conducted between November 15-December 20, 2025, included practicing physicians in Türkiye. A 26-item online questionnaire assessed demographics, opioid knowledge, prescribing habits, and concerns. The Opioid Knowledge Score (OKS; range 0–23) assessed understanding of indications, derivatives, classifications, and dose equivalence. Concerns were rated using a Likert scale. Results: A total of 800 physicians participated, including family physicians (19.6%), internal medicine specialists (18.6%), anesthesiologists (15.3%), surgeons (14.2%), medical/radiation oncologists (7.0%), and other specialties (25.3%). 68.5% had no prior opioid training, and 62.6% were prescribers. The median OKS varied by specialty (P<0.001), with anesthesiologists [16(11–23)] and oncologists [16 (4–23)] achieving the highest scores, while surgeons had the lowest [13 (7–19)]. Prescribers were more likely to have prior training (39.1% vs. 18.7%, P<0.001) and higher OKS scores [16 (4–23) vs. 13 (5–22), p<0.001]. Concerns about opioid addiction and side effects were evaluated using Likert scales. Non-prescribers had higher concern levels (P<0.001). Higher OKS reduced concerns about addiction (OR: 0.911, 95% CI: 0.867–0.958) and side effects (OR: 0.912, 95% CI: 0.868–0.959, P<0.001). Family physicians reported the highest concern regarding addiction (OR: 11.42, 95% CI: 6.12–21.29, P<0.001) and side effects (OR: 4.94, 95% CI: 2.70–9.03, P<0.001) compared to oncologists. Lack of opioid training increased concerns about addiction (OR: 1.59, 95% CI: 1.15–2.21, P=0.005) and side effects (OR: 1.46, 95% CI: 1.05–2.02, P=0.024). Conclusions: Gaps in opioid knowledge and concerns among Turkish physicians highlight the need for targeted education to reduce specialty-specific barriers and improve pain management. Ordinal regression analysis for factors influencing addiction and side effect concern. Addiction Concern Side Effect Concern Variable Odd’s ratio 95% CI P value Odd’s ratio 95% CI P value Opioid knowledge score 0.911 0.867-0.958 <0.001 0.912 0.868-0.959 <0.001 Specialty, n (%) Family medicine Internal medicine Medical/Radiation oncology Anesthesiology/Algology Surgery Other 11.424.651(Ref)8.707.784.66 6.12-21.292.61-8.284.85-15.624.25-14.222.47-8.78 <0.001<0.001<0.001<0.001<0.001 .942.441(Ref)4.934.522.60 2.70-9.031.39- 4.302.78-8.732.49- 8.171.40-4.85 <0.0010.002<0.001<0.0010.003 Years in practice, n (%) 0-5 >5 11.01 0.94-1.71 0.120 11.08 0.80-1.46 0.604 Opioid Training, n (%) No Yes 1.591 1.15- 2.21 0.005 1.461 1.05-2.02 0.024