their community (81.8% vs. 70.3%, p<.05). There were no differences between age groups on the belief that opioids are affecting their community. The majority of participants indicated that when looking for general health information, they sought information from their healthcare provider (77%), the internet (59.7%), family/friends (54.3%), books (22.4%), and pamphlets (22.1%) (Table 3). When asked what sources they would pursue for opioid-specific information, the order of the sources was the same, but the percentage of those indicating they would seek information from a health care provider increased to 86.6%. Other categories include the internet (59.1%), family/friends (49.3%), books (26.9%), and pamphlets (23.3%). Furthermore, fewer participants reported coming across information about prescription opioids when not actively looking for it than those who said they had not (115/ 34.30% vs. 139/ 41.5%). In the final question, designed to assess where individuals are currently receiving information about opioids when they are not actively looking for it, they reported hearing from healthcare providers at a much lower rate and behind other sources: television (60%), internet (54.9%), family/friends (47.5%), healthcare provider (46.2%), and social media (40%). Discussion These results indicate that individuals in Mississippi are interested in obtaining information about opioids from their healthcare providers and fit with a emerging body of research on the importance of physicians and other health care professionals integrating substanceabuse prevention and detection skills into their encounters with patients. Recent Centers for Disease Control and Prevention (CDC) guidelines on prescribing opioids recommend that providers discuss the risk and benefits of opioid therapy as well as clinician responsibilities, including the dangers to other household members beyond the patient.19 The CDC also suggests that physicians have conversations with their patients about alternative treatment options to prescription opioids to treat chronic pain. Based on the results of this study, there appears to be opportunities for Mississippi healthcare providers to provide increased opioid-related education to patients who welcome such information. This is particularly important given data on opioid misuse in Mississippi showing that for ages 12 and over, 4.3% of Mississippians misuse opioids and 7.30% of Mississippians age 18-25 met criteria for opioid misuse. 20 These rates are comparable to the percentages in the overall United States and slightly higher than those in the Northeast and the South overall. Prior research has examined differences in health information seeking by gender, socioeconomic status, ethnicity, and other factors. Women are more likely than men to look for health information in general and more likely to use the internet for information seeking;21 people with lower levels of education are generally less likely to seek health information than those with higher education levels; and there are some differences in information seeking associated with ethnicity.22,23
We hope to examine whether this same difference exists in the context of opioid information seeking and scanning in future studies. The CDC guidelines also recommend initial and ongoing evaluation for substance abuse and potential for misuse. More recently, the US Preventive Services Task Force released a recommendation statement endorsing both screening and brief behavioral counseling interventions for unhealthy alcohol use in primary care settings in adults.24 One example of this approach is Screening, Brief Intervention, and Referral to Treatment for substance use (SBIRT), an evidencebased approach to conducting screenings for substance misuse providing brief interventions designed for physicians to integrate into their clinical practice. It can include screening for opioids in addition to other drugs of abuse and alcohol.25 While SBIRT is a part of the University of Mississippi Medical School , research suggests that SBIRT takes too much time for physicians; therefore, training nurses, office personnel, and volunteers to provide this information under the supervision of physician could be effective.26 Providers have 1530 minutes with each patient; therefore, it might be challenging for providers to discuss opioids with every patient. Thus, providers could deliver opioid-related information through a short video in the waiting room, written materials, or trained staff, all of which are approaches supported by SBIRT. Limitations While this study provides valuable insights into how information on opioids can be shared with Mississippians, there are limitations to our study. First, our cohort may not be precisely representative of the state since it was not constructed using random sampling. Second, we do not know how many participants saw a healthcare provider in the past 12 months. In future research, we will include a variable asking that question, and we recommend that other investigators do the same. Third, we do not have a measure of opioid information seeking from all sources, only a general measure. Nonetheless, we are confident that these findings support the need for more and better communication between patients and healthcare providers on matters related to opioid misuse prevention. Conclusion The results from this study are congruent with recent recommendations made in Mississippi opioid prescribing guidelines. They identify the need for Mississippi physicians and other health care providers to discuss benefits and risks and provide evidence-based information on opioids to Mississippians interested in receiving it.27,28 n References 1. Hedegaard H, Warner M, Minino AM. Drug overdose deaths in the United States, 1999â&#x20AC;&#x201C;2016. National Center for Health Statistics Data Brief, No. 273, February 2017. 2017;(273):8. https://www.cdc.gov/drugoverdose/index. html. Accessed December 1, 2018. 2. Florence CS, Zhou C, Luo F, Xu L. The economic burden of prescription opi-
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