The opioid drug has been prescribed to patients with chronic pain. However, there is an increase in its abuse among patients which has been due to factors such appropriate prescription (Aronoff 2016). The abuse of this drug can lead to addiction, and therefore there are various ways in which this addiction can be prevented and reduce. One such approach is the evidence-based approach, nursing interventions, and practices. This helps in enhancing patient care and reduction and prevention of abuse in the long run.
Evidence-based solution of opioids abuse in pain management
Opioids are essential in the treating of chronic pain. However, they have a limited role. Practitioners are challenged by how to make the drug available to only those in serious need (Oliver et al. 2012). It brings the issue of using evidence-based means to prevent the abuse. An example of the evidence-based solution is algorithm approach to reducing of the substance abuse. In the case of the failures of other measures, three steps can be used. The three ways of preventing drugs abuse would be through the stratification of patients through the application of screening tools, use of UDS, PMP's and pill counts to monitor patients and establishment of limits to the dosage.
It is important to first stratify the patients into various sections using the established tools for examining opioid misuse. In case a patient is classified as high risk, their monitoring should be close with the inclusion of USD and PMP tests (O'Brien 2014). The prescription of Opioid in their treatment should be discouraged or done in low dosage. There should be no prescription for patients who show abnormal behavior, and therefore counseling should be explored (Arlotta 2015). The medium risk patients should be monitored using USD tools, and there should be the assessment of prescription, and in the case of abnormal behavior, counseling should be the option. Another issue to be put into consideration would be having patients with designated prescribers to avoid instances of the increase in dosage, establishment of follow-ups and enlightenment about the risks.
Nursing interventions for opioids abuse
Nurses are professionals who are trusted and act as both patient and family educators. It means nursing interventions can help in the reduction of the serious cases of opioid abuse. The interventions include:
Teaching and provision of information concerning risks, diversion of the drug and consequences of using it non-medical purposes (Morgan 2014).
There should be the provision of substance disposal control. The nurse can inform the patients that medicine should be disposed of as soon as they are not required.
The nurses should also ensure that the utilization of opioid in managing pain is monitored to minimize abuse of the drug (O'Brien 2014).
Patient care can be ensured through the implementation of patient-centered care strategies. The caregivers should ensure that they establish the sight of misuse and provide suggestions for possible treatment (Dunbar 2016). They should also ensure that opioid is administered according to regulations to ensure there are no consequences on the long-term. Therefore safety measures in prescription should adhere to by the clinicians.
Health Care Agency on Opioid Abuse
The Office of the National Coordinator for Health IT has enlisted three ways in which health IT can help combat the issue of opioid crisis in pain management (Cherny 2015). One way is the utilization of clinical decision support which is the enhancement of health-related decisions and activities in essentially organized information and knowledge geared towards better delivery of healthcare (Boscarino et al 2015). The other is the use of electronic means of prescription to minimize the abuse of drugs. Another this is the implementation of monitoring programs in dealing with the opioid abuse menace.
Nurses should ensure:
The Proper diagnosis with the required differential.
Conduction of appropriate patient assessment.
The Reassessment of patients with chronic pain.
Keeping of all patient medical records (St. Marie 2016).
Currently, there is serious abuse, diversion, and the overdose of prescription drugs which are resulting in deaths. The problems have been increased by the growth in the issue of chronic pain which has resulted in abuse of the medication. Nurses are in the best position to help in the reduction of this epidemic. To do this, they need to have relevant skills and knowledge in pain management and prescription of drugs.
Arlotta, C.J (2015, FEB 25). Patients with substance abuse history are more likely to misuse therapeutic opioids, Study Finds. Retrieved from https://www.forbes.com/sites/cjarlotta/2015/02/25/patients-with-substance-abuse-history-are-more-likely-t0-misuse-therapeutic-opioids-study-finds/#51f1250555d7
Aronoff, G. M. (2016). Complications of Opioid Therapy. Controlled Substance Management in Chronic Pain, 10(2), 135-161. doi:10.1007/978-3-319-30964-4_9
Boscarino, J., Hoffman, S., & Han, J. (2015). Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates. Substance Abuse and Rehabilitation, 83. doi:10.2147/sar.s85667
Cherny, N.I. (2015). Oxford textbook of palliative medicine. New York: Oxford University Press.
Dunbar, S.A (2016). Chronic Opioid Therapy in Patients with a History of Substance Abuse. Topics in Pain Management, 11(11), 41-43. doi: 10.1097/00587875-199606000-00001
Franklin, J.S., & Savage, S.R. (2013). Opioid Therapy of Chronic Pain in Persons with Known Substance Use Disorder. Expert Decision Making on Opioid Treatment, 15-26. doi:10.1093/med/9780199768882.0003.0002
Gurewich, D., Prottas, J., & Sirkin, J. T. (2014). Managing Care for Patients with Substance Abuse Disorder at Community Health Centers. Journal of Substance Abuse Treatment, 4692), 227-231. doi: 10.1016/j.jsat.2013.06.013
Knopf, A. (2015). CDC issues draft opioid prescribing guidelines for chronic pain. Alcoholism & Drug Abuse Weekly, 27(48), 506. doi:10.1002/adaw.30424
Miltra, S., Sinatra, R.S.S & McQuay, H. (2014). Acute Pain Management in Patients with Opioid Dependence and Substance Abuse. Acute Pain Management, 564-50. doi:10.1017/cbo970511576706.036
Morgan, B. D. (2014). Nursing Attitudes toward Patients with Substance Use Disorder in Pain. Pain Management Nursing, 15(1), 165-175. doi:10.1016/j.pmn.2012.08.004
Morley, G., Briggs, E., & Chumbley, G. (2015). Nurses Experiences of Patients with Substance-Use Disorder in Pain: A Phenomenological Study. Pain Management, 16(5), 701-711. doi:10.1016/j.pmn.2015.03.005
OBrien, C. (2014). Managing patients with history of substance abuse. Can FAM Physician, 60(3), 248-250.
Oliver, J., Coggins, C., Compton, P., Hagan, S.s Matteliano, D., Stanton, M., Turner, H. N. (2012). American Society for Pain Management Nursing Position Statement: Pain Management in Patients with Substance Use Disorder. Pain Management Nursing, 13(3), 169-183. doi:10.1016/j.pmn.2012.07.001
St. Marie, B. (2016). The Experiences of Advanced Practice Nurses Caring for Patients with Substance Use Disorder and Chronic Pain. Pain Management Nursing, 17(5), 311-321. doi:10.1016/j.pmn.2016.06.001
Webster, L. R. (2016). Risk Mitigation Strategies. Controlled Substance Management in Chronic Pain, 163-180. doi:10.1007/978-3-319-30964-4_10
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