Physician Opioid Prescribing Attitudes in Michigan: An Exploratory Pilot Study of Age-Gender Interactions and the Awareness-Uncertainty Paradox

Background Physician attitudes toward opioid prescribing directly influence patient access to pain management while potentially contributing to misuse. This exploratory pilot study examined the demographic predictors of physician opioid prescribing attitudes in Michigan and explored relationships between risk awareness and prescribing difficulty. Methods This cross-sectional exploratory survey assessed opioid-prescribing attitudes among 51 practicing physicians in Michigan. Prescribing caution was measured using three Likert scale items, with composite scores analyzed using t-tests, analysis of variance (ANOVA), and multiple linear regression to test demographic predictors and interactions. Results No significant main effects emerged for rural versus urban practice (P=0.906), gender (P=0.554), or specialty type (P=0.532). However, a potential age×gender interaction was observed (β=0.330±0.15, P=0.033), suggesting that age effects on prescribing attitudes may differ between male and female physicians. Physicians recognizing opioid misuse as a patient problem tended to report greater prescribing difficulty (r=0.611, P<0.001, 95% CI (0.41, 0.76)). Condition-specific endorsement revealed patterns favoring cancer pain (50/51, 98.0%) and sickle cell disease (40/51, 78.4%), with lower endorsement for headaches (4/51, 7.8%) and fibromyalgia (2/51, 3.9%). Conclusions This preliminary study suggests that awareness of opioid risks may be associated with increased clinical uncertainty. Age and gender may interact in complex ways that warrant further investigation in larger samples. Future research should explore whether educational interventions addressing both risk awareness and decision support could reduce prescribing uncertainty.