Access to primary care is limited for patients taking opioids for chronic pain, particularly for patients with histories suggestive of aberrant use of opioids, according to a study published in Pain. Investigators conducted a secret shopper audit survey of primary care clinics in nine states (May to July 2019). Simulated patients taking opioids for chronic pain called clinics claiming to need a new provider either because their previous physician had retired or stopped prescribing opioids for unspecified reasons. Clinic willingness to see the patient and prescribe opioids was assessed. Among clinics, 452 responded to both scenarios (904 calls). More than four in 10 clinics (43%) said their providers would not prescribe opioids in either scenario, while just under one-third of clinics (32%) said their providers might prescribe in both. Onefourth of clinics (25%) responded differently to each scenario, with greater willingness to prescribe when the previous doctor retired versus when the doctor had stopped prescribing (odds ratio, 1.83).

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