Doctors who try to wean patients off opioids or refuse to prescribe the medications say they face increasing threats of violence, the Associated Press reports.

“We’ve had patients waiting for doctors in parking lots to harass them. We’ve had them say ‘We’re going to shoot you’ or ‘We’re going to burn your house down,’” said Dr. Carrie DeLone, regional medical director at Penn State Health Community Medical Group.

According to Dr. W. Michael Hooten, president-elect of the American Academy of Pain Medicine, almost half of pain specialists surveyed during a violence education session in 2019 cited opioid management as the reason they had been threatened.

Some doctors have installed alarm systems and panic buttons. They have set up exam rooms so they are closest to the door. Hooten said smaller clinics, which may not be able to afford security, are at greatest risk.