Advanced Practice Nurses: Opioid Prescription for Noncancerous Pain - Essay Sample

Introduction

Several approaches can be employed to determine whether Advanced Practice Nurses (APNs) can prescribe opioids to manage chronic noncancerous pain within an outpatient setting. The risk factors due to increased dependency on opioids are some of the clinical management issues that should be considered before prescribing the drug for chronic non-cancerous patients (Yajnik et al., 2019). Many cases are arising due to the misuse of opioids, including overdosing that has severe effects on their health. Overdependence can lead to addiction, which later leads to abuse of the drug. APNs should seek and use alternative measures of managing chronic pain to avoid possible addictions.

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Phenomenon of Interest

This particular subject is of attention because nurses are usually the frontline care providers, as well as need to be comprehensive in embracing established policies on incorrect use as well as abuse of opioids. The opioid drug abuse menace has been brought up by things like ineffective prescribing, absence of best methods in assessment and interpretation of discomfort levels, and inconsistency with laws at authorities and policy enactors. Therapy of prescription OUDs in psychological health centers is now remarkably widespread. A statement by the CDC in 2015 proved the growing use of prescription opioids resulted in an exponential growth in deadly opioid overdoses totaling much more than 17,000 deaths a year (Dowell, Haegerich & Chou, 2016). Sticking to the increased mortality risk with opioids, there continues to be a call to providers for enhanced medical instruction, knowledge, and also mandates in prescribing opioids for non-cancer pain control. In the United States healthcare system, with adequate express as well as DEA train license, any doctor, or maybe nurse practitioner may recommend opioids (Dowell, Haegerich & Chou, 2016).

POI Significance to APNs

APNs must think about the assessment tools that are used in determining as well as monitoring the patients who are at risk. This measure could assist in identifying people that are actually in pressing need of pain-relieving drugs to watch the use of opioids to stay away from dangers of dependency (Chen et al., 2016). It's the job of the APNs and also the doctors to figure out the rational sense of balance in minimizing the possibility of adverse effects as well as addiction to opioids. A bridge of ethical compliance in regards to the use of opioids can come about when an APN declines to recommend opioids, and the individual indeed require it for pain relief. The main concern is determining ways to stay away from the prescription of opioids without leading to injury to the client. Likewise, staying away from prescribing opioids to individuals in pain will be like avoiding one crisis to cause the other, hence, not offering an excellent strategy to drug dependency (Nuckols et al., 2014). Likewise, APNs must recognize that individuals with persistent pains are unable to stay away from the usage of opioids since the search for extremely effective methods is regarded as ineffective for many, and they will instead take measures to stay away from addiction than stay away from prescription.

The primary problem is the absence of information on the principle-based and deontological ethics on the prescription of opioids. Likewise, there's a difference in figuring out the sensitivity of the individuals needing opioids. Several experiments have suggested that opioid increases affected person sensitivity to pain hence hard to stay away from its use. Additionally, APNs encounter issues in reducing adverse effects as well as the risks which are connected with opioid analgesics (Franklin, 2014). There's a need to create an abuse-deterrent opioid formulation to assist in medication treatment.

The Problem, Interaction, Comparison, and Outcome

According to Karhade et al. (2019), the opioid pandemic has turned into a severe obstacle to public health, resulting from the increase in the use of equally prescription and nonprescription opioids. Abuse and misuse of drugs in the Country would be the significant causes of death and damage, and nurses must get involved in enhancing the situation by teaching individuals, the families of theirs, and also the general public regarding the current opioid medicine pandemic (Waszak et al., 2018). This aspect can require nurses to start by bettering their knowledge and understanding of the problem, adequately and appropriately evaluating as well as controlling soreness, and championing for proper use of opioid medicines.

There are alternatives to the use of opioid medicines, which are also useful in pain management (Yajnik et al., 2019). Nevertheless, based on Reid et al. (2019), various hurdles to the usage of opioids are available, which will stop the APNs from using these medicines to the full potential for sufficient pain control. The distribution of opioids signifies a sizable imbalance, with only approximately eighteen percent of the worldwide community consuming a whopping ninety-two percent of the global source. The ratios of the complete universal morphine supply ingested by The United States, Europe, and Canada, respectively around 2009 were six percent, twenty-eight percent, and fifty-six percent (Yajnik et al., 2019).

Most opioids medicines have similar chemical compositions hence mode of action. They intermingle with opioid receptors in mind as well as the body's nerve cells. Pain reliever opioids, however, would be the very best medication for pain management, are just safe when used based on the pharmacists as well as doctors' prescription and for a quick time. Nevertheless, these prescription drugs may be abused or misused since they do not merely relieve discomfort but additionally create euphoria (Mallick, Searle, & Chang, 2018). Besides, the standard uses of these medicines are based on the prescription by a medical practitioner since they could cause dependence. When misused or even abused, these prescription drugs can result in incidents of overdose, addiction, and also death.

Research has suggested the expertise of nurses regarding opioids can provide a positive change in the way these medicines are used (Sullivan et al., 2016). Nursing exercise is identified by caring. Watson Jean, in the theory of his of Human Caring, contends that thoughtful renews living energies and potentiates the capabilities of people (Sullivan et al., 2016). The principle promotes self-actualization at each personal and professional level. Based on the concept, nurturing comes about mutual advantages for both the caring nurse and also the individuals, and even among all members of the medical teams, which includes doctors. Pain assessment is a crucial step towards providing excellent pain control. The vital part of the analysis of pain is it's performed frequently in a regular format. To meet up with the requirements of individuals, painfulness has to be reassessed, adhering to every intervention to assess the effect & figure out in case modification is needed.

Position Statement Critique

As the focus switches from opioid for persistent pain management, little proof exists for helpful long-lasting alternatives (Waszak et al., (2018). Access is limited to particular recommendations for non-opioid pharmacologic therapy with tactics like biopsychosocial rehabilitation, cognitive-behavioral treatment, and training therapy despite their ability to reduce overdose danger (Waszak et al., (2018). Improving patient consciousness of the remedies for OUDs and also lessening financial hurdles to addiction treatment will better the accessibility of life-saving remedies that may influence the opioid overdose mortality rate (Dowell, Haegerich & Chou, 2016). Executing risk reduction actions including staying away from high-risk prescription drugs such as transdermal fentanyl, methadone, along with mixtures of prescriptions and opioids of benzodiazepines and also talking about state prescription policy directories are methods that nurse practitioners, as well as doctors, can take to improve the security of the people of theirs on opioids.

How Position of Statement Impacts Quality

Medical Policy and Research Agency offers a guideline for pain control (Costello & Thompson, 2015). The recommendations create an extensive framework of soreness assessment, which may be very beneficial when obtained prior to surgical methods (Costello & Thompson, 2015). In the story of soreness, APNs must determine the beliefs, perceptions, ultimate discomfort experiences, and understanding victims. To get this done, the APNs employ the principle of human caring, as suggested by Watson. This aspect will allow the nurse to embrace positive power flowing out of an integrated put, mind, spirit, and body, the individual in the very best position for self-healing.

Conclusion

APNs should embrace the existing alternative measures to the use of opioids in relieving chronic pain. This measure is essential in curbing the possible side effects due to the use of opioids that includes overdependence and addiction. However, APNs should not decline from prescribing opioids to all chronic noncancerous patients since denying those who are in dire need of the drugs may be trading a crisis for another. Therefore they should be used appropriately as the APNs seek alternative procedures of managing chronic pain to avoid possible addictions.

References

Chen et al. (2016). Distribution of opioids by different types of Medicare prescribers. JAMA Intern Med;176:259-61

Costello, M., & Thompson, S. (2015). Preventing Opioid Misuse and Potential Abuse: The Nurse's Role in Patient Education. Pain Management Nursing, 16(4), 515-519. Retrieved from http://dx.doi.org/10.1016/j.pmn.2014.09.008

Dowell, D., Haegerich, T.M., & Chou, R. (2016). CDC Guideline for prescribing opioids for chronic pain-United States, 2016. Morbidity and Mortality Weekly Report, Recommendations and Reports 65, 1-49.

Franklin, G.M. (2014). American Academy of Neurology. Opioids for chronic noncancer pain: a position paper of the American Academy of Neurology. Neurology, 83(14):1277-1284.

Karhade, A. V., Chaudhary, M. A., Bono, C. M., Kang, J. D., Schwab, J. H., &Schoenfeld, A. J. (2019). Validating the Stopping Opioids after Surgery (SOS) score for sustained postoperative prescription opioid use in spine surgical patients. The Spine Journal, 19, 1666-1671.

Mallick-Searle, T., & Chang, H. (2018). The importance of nurse monitoring for potential opioid abuse in their patients. Applied Biobehavioral Research, 1-12. DOI: 10.1111/jabr.12129

Nuckols et al. (2014). Opioid prescribing: a systematic review and critical appraisal of guidelines for chronic pain. Ann Intern Med, 160:38-47

Reid, D. B., Shah, K. N., Ruddell, J. H., Shapiro, B. H., Akelman, E., Robertson, A. P., ... Daniels, A. H. (2019). Effect of narcotic prescription limiting legislation on opioid utilization following lumbar spine surgery. The Spine Journal, 19(4), 717-725. DOI: 10.1016/j.spinee.2018.09.007

Sullivan et al. (2016). Trends in opioid dosing among Washington state Medicaid patients before and after opioid dosing guideline implementation. J Pain, 17:561-8

Waszak, D. L., Mitchell, A. M., Ren, D., & Fennimore, L. A. (2018). A Quality Improvement Project to Improve Education Provided by Nurses to ED Patients Prescribed Opioid Analgesics at Discharge. Journal of Emergency Nursing, 44(4), 336-344. DOI: 10.1016/j.jen.2017.09.010

Yajnik, M., Hill, J. N., Hunter, O. O., Howard, S. K., Kim, T. E., Harrison, T. K., & Mariano,...