Because of the high rates of morbidity and death associated with opioid use disorder, many states have passed legislation to restrict opioid prescribing, including West Virginia’s Senate Bill 273. This research examines how a recent law in West Virginia that makes it harder for doctors to prescribe opioids has affected their daily work. 

West Virginia doctors were selected randomly for this semi-structured, open-ended qualitative interview study. Transcripts of the interviews were taken word for word. The team of 3 co-investigators created a basic code book. Then, a text search query based on codes was used to examine the interview transcripts. The current study relies on the content-analytic methodology as its theoretical foundation. The 20 doctors interviewed in West Virginia included 10 general practitioners and 10 specialists. 

Physicians identified a total of 5 theoretical domains as being connected to SB273: shifting opioid prescribing and documentation requirements, socioeconomic disparities in rural areas, a continuum between chronic pain and substance use disorder, the challenge of balancing patient needs with the worry of diversion, and a shortage of alternatives to opioids for chronic pain. The highlighted difficulties make it difficult to prescribe opioids in rural West Virginia. Clear messaging of guidelines and recommendations, efforts to address socioeconomic disparities of health and pain, and improved accessibility for treatment of both pain and dependence in rural communities are all important areas of growth in the rural healthcare environment, and all are recommended for opioid prescribing legislation.