Nurse Role to Combat the Opioid Epidemic

Introduction

In the past several years, the opioid addiction has become exponentially greater with more and more deaths occurring daily. The Centers For Disease Control and Prevention report that the opiate related deaths are a public health crisis with an average of 130 Americans dying as result of an overdose daily (CDC, 2018). An opioid is a drug used to relieve pain and noted to work by inhibiting pain signals sent to the brain (Bradley University). Some examples of opioid medications are codeine, morphine, oxycodone and hydrocodone. Congress passed the bill titled H.R. 6 titled Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act. In effort to address the opioid crisis, this bill will allow for additional funding of medical professionals with continuing education and improve prescription drug monitoring programs in addition to increasing research for different approaches for pain treatment and treatment modalities instead of the heavy dose opioids. Physicians have been loosely prescribing opioid medications to patients who report severe pain and with the high addictive properties that opioids have is the foundation of opioid abuse. Therefore, the growing population of opioid addictive users constitutes the current crisis that has been going on killing many it could have been prevented. Because the fatality that this crisis has put on society, the government has taken action to seize this epidemic. In addition, nurses compose a vast majority of the healthcare workplace therefore the necessity to educate nurses on addiction specifically opioids in order to better provide the best possible care for their patients can make a substantial difference in combating opioid addiction.

Background

It was in 1991, when there was an increase in physicians prescribing opioids for treatment of pain because pharmaceutical companies began to provide reassurance to prescribers that risk for addiction was particularly low and society would not be affected (Liu, Pei, Soto, n.d.) In addition, pharmaceutical companies also stressed the use for opioids in non-cancer patients with no data to outweigh and risks and benefits. This misleading information led to over 80 percent of users being non-cancer patients who reported pain and thus given an opioid prescription to help relieve the pain. As the years went on there was an increase in opioid prescriptions being given out which also led to misuse of the medication and diversion meaning giving medication to others who are not prescribed. As a result, research found that these pain prescriptions were highly addictive and the addictive population continued to grow leading to more deaths related to overdoses and illicit use. In 2017, there was an estimated 1.7 million people in the United States who suffered substance abuse related to prescription opioid pain relievers (National Institute on Drug Abuse, 2019). Today, the addiction has become so widespread and affecting millions of people that it has become a national public health crisis with many efforts now in place to attempt to decrease this devastating epidemic.

Government Actions to Combat Opioid Addiction

According to Russell (2017), the White House has created and initiated a requirement that address the lack of physicians controlling the number of opioids they prescribe. The initiative that they created now requires federally employed healthcare providers who indeed prescribe opioid medications to complete a training that focuses on opioid prescribing. Since this initiative has been ruled out, there have been thousands of healthcare providers completing the training. Furthermore, the American Public Health Association (APHA) has created a policy to further provider education on evidence- based programs focusing on substance abuse, mental health, risks of high dose opioid therapy, and non-pharmacological alternatives to treat pain (Russell, 2017). Finding a way to treat chronic pain without the need to continually prescribe opioid as well as safely assessing the patient for follow-ups when currently taking an opioid for pain is the necessary steps that as a country the government needs to provide great focus on. The National Institutes of Health, recently created a Helping to End Addiction Long-term (HEAL) effort to accelerate scientific based solutions to address and combat the opioid public health crisis (NIH). This initiative has a plan to target a great deal of research with the main topics focusing on improving prevention and treatment for opioid misuse and addiction and enhancing pain management. When this approach and research is completed, the country will be able to have the necessary tools to end the crisis and prevent it from reemerging in later future. Although there are many other approaches that have been done, I will focus the last government approach on the president’s commitment to target this devastating crisis and affect it has had in many communities and many Americans. President Trump’s initiative to stop the opioid abuse consisted behind the driving forces in which entails the easy accessibility and over prescription, controlling the amount of international and domestic supply that hit the communities, and providing evidence-based approaches and treatment as well as recovery services. As stated previously, one of the largest legislative bill that address a specific drug emergency in history was passed last year. With this new nationwide policy, the change will without doubt positively benefit both patients and healthcare providers with the additional funding and increased prescription drug monitoring allowing physicians to be more cognizant and not abuse the way in which they prescribe such pain medications. With that said, there will be improved, safe and effective opioid prescriptions.

Nurse Role in Educating and Succoring Opioid Epidemic

Nurses interact, care and treat many individuals with all different backgrounds and issues. Within the past several years as the addictive population specifically the opioid crisis has become much more severe with an increased number of patients, they encounter face addiction. The result of this epidemic affects all individuals and families across all lifespans and are seen in every aspect of nursing (Painter, 2017). When faced or confronted with a patient who battles addiction, there is the importance of building a trusting relationship to allow for the patient to a safe environment to confess their addiction. Within the nursing community, nurses can have a very impactful say in advocating for awareness and change. However, like many other healthcare professionals there is lack of specialized training in dealing with the addicted leading to an unsuccessful or complete absence in educating patients on how they can overcome their addiction. Jozaghi and Dadakhah-Chimeh (2018) touched upon the potential to more appropriately screen and treat those who suffer with substance abuse by incorporating nursing strategies and interventions which strictly focus on addiction. One approach that can begin in the early years of a nurse is within nursing programs to allow for young nurses to build an eye for substance abuse, addiction and those at risk (Jozaghi & Dadakhah-Chimeh, 2018). There are certain factors and populations that are at higher risk of dying from and overdose related events. With the knowledge of certain factors that can play in the higher incidence of overdose deaths, enhancing education can play a critical component in the healthcare system to visibly see improvements and begin to overcome this crisis in addition to decreasing opioid related cases.

As mentioned above, nurses say can without a doubt have a strong influence on recommendations that can be deemed appropriate to battle this crisis in addition to advocating for patients to provide better access to treatment options. Many nurses are involved in professional nursing organizations which can be an outlook to advocate through to further push the importance of how detrimental this opioid epidemic is affecting millions of people (Hahn, 2018). Furthermore, research has shown the lack of teaching within the realm of patient risks associated with opioid use especially to those who take it for nonmedical use. There is evidence that when nurses teach patients about the medications, they lack to provide the proper way to secure and dispose of controlled substances that have been prescribed to them (Manworren & Gilson, 2015). One way in which this opioid addiction has become such a public health emergency is due to what is known as diversion and for nonmedical use. Many ways in which diversion occurs is through family and friends. Over 90 percent of individuals receive opioid prescriptions from a family or friend which is an astounding statistic (Messer, 2017). Putting this into perspective, a family member or friend has been prescribed an opioid and offers it to another person who reports increased pain. After that non-prescribed individual consumes the medication and enjoys the effect, it slowly begins to affect the brain receptors and with the highly addictive properties that opioids have they begin to want more, and the road to addiction begins. Teens and adolescents have a belief that a prescribed medication is regarded as safer than street drugs and take others medications (Messer, 2017). Simple nursing interventions that can be implemented within nursing routine educations is educating patients on risks of opioid diversion, provide proper education on controlled substance disposal and track opioid consumption for those who suffer from acute and chronic pain conditions (Manworren & Gilson, 2015). Likewise, with the new state implementations of drug monitoring programs and if permission is provided, nurses can access the program to track opioid use. Nurses can play a pivotal role in addressing and reducing the opioid addiction and overdose related deaths. Nonetheless, a combination of improved and specialized nursing education and public health strategies can further support and provide a greater foundation to tackle the occurrences of opioid addiction. As a collaborative effort between healthcare providers and nurses, providers should be more cautious in prescribing opioids to acute or chronic pain patients and nurses should be trained in identifying and understanding practical measures to address to aid the provider in alternatives in addition to educating the patients about the various risks (Higgins & Simons, 2019).

References

1. CDC- Understanding the Epidemic. (2018). Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
2. Congress.GOV- H.R. 6- Support for Patients and Communities Act (2017-2018). Retrieved from https://www.congress.gov/bill/115th-congress/house-bill/6
3. Hahn, J.A. (2018). The American opioid epidemic: A policy update. Virginia Nurses Today.
4. Higgins, S.A., & Simons, J. (2019). The opioid epidemic and the role of the occupational health nurse. Workplace Health & Safety, 67(1), 36-45.
5. https://www.drugabuse.gov/drugs-abuse/opioids/opioid-overdose-crisis
6. Jozaghi, E., & Dadakhah-Chimeh, Z. (2018). A call for action to combat the growing synthetic opioid epidemic: The need for the creation and expansion of addiction and psychiatric nursing programs. The Journal of School Nursing, 34(1), 11-13.
7. Liu, L., Pei, D.N., & Soto, P. (2012-2019). History of the opioid epidemic. Retrieved from https://www.poison.org/articles/opioid-epidemic-history-and-prescribing-patterns-182
8. Manworren, R.C., & Gilson, A.M. (2015). Nurses’ role in preventing prescription opioid diversion. The American Journal of Nursing, 115(8), 34-40.
9. Messer, A. (2017). Nurses working together to fight the opioid epidemic. The Mississippi RN, 12-13.
10. National Institute on Drug Abuse- Opioid Overdose Crisis (2019). Retrieved from
11. National Institutes of Health- HEAL Initiative Research plan (n.d.). Retrieved from https://www.nih.gov/research-training/medical-research-initiatives/heal-initiative/heal-initiative-research-plan
12. Painter, S.G. (2017). Opiate crisis and healthcare reform in America: A review for Nurses. The Online Journal of Issues in Nursing, 22(2).
13. Russell. K. (2017). The opioid epidemic: A national response and nursing’s contribution to ending the crisis. Dean’s Notes, 38(3).

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