The Opioid Crisis: Is Nurses' Knowledge Enough to Combat It? - Essay Sample

Introduction

The debate on whether the nurses' knowledge on opium/crisis/substance is sufficient to fight the current opioid has attracted attention among the stakeholders in the American health sector. The use and abuse of illicit and prescription drugs has risen drastically in the recent times. A most alarming outcome is the fact that the accessibility of addictive opioids has increased. The addiction of opium has a negative impact on individuals because it deteriorates their social lives. Drugs including fentanyl and morphine alleviate pain among patients when used suitably. However, opium tends to be addictive and susceptible to abuse. The opioid epidemic is a stringent public health issue in the nation because of the rising use of nonprescription and prescription opioid medications. Substance abuse is a dominant cause of injury demise in the country, and as nurses, they have the obligation to get involved and educate the public regarding the current opioid crisis. For a long time, the nurses have attempted to increase their knowledge and understanding the issue, sufficiently and appropriately evaluating and administering pain, and agitating for accountability in consuming the opioids. The current nurses do not have sufficient knowledge on opioids-related content and nursing schools/hospitals are not providing enough education on pain/opioid/substance to nursing students/nurses.

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Evidence

Opioid Crisis

The opioid crisis is a severe health problem resulting from the use of prescription and non-prescription opioid drugs in pain relief in the US and all around the globe. Opioids are strong pain relievers that are either made from the opium plant or synthetic. They include fentanyl, tramadol, oxycodone, hydrocodone, and also heroin. A prescription opioid functions to reduce pain after major surgery or injury, for chronic pain and severe pain from a health condition such as cancer. The misuse of these drugs has been evident in many cases where patients take too much medicine for quick pain relief or use medication to get high. There are instances where people use other people's medicine and end up using them the wrong way. These drugs do reduce not only pain but also have side effects that can lead to overdose death as many become addicted and dependent on them i.e., cannot do without them. Misuse of opioids during pregnancy can result in babies being addicted and cause neonatal abstinence syndrome (NAS).

Medication-assisted treatment (MAT) is used to treat prescription opioid addiction. The patient gets help on how to stop using the drug, how to cope with cravings, and withdrawal symptoms through medicines ( e.g., naloxone, medication Subutex (buprenorphine) and Suboxone (buprenorphine and naloxone combination), counseling and necessary support from those around him/her. It can also reduce costs, deaths, the spread of diseases, and crime. In using prescription opioids, follow the doctor's instructions, keep the medicine well, and not shared with others.

Nurses believe that opioids are safe and efficient in treating various forms of pain. This false sense of safety and under treatment has often resulted in abuse and addiction to opioids. According to studies, opioid use disorders (OUD) involving prescription opioids have affected at least 2 million people, and those associated with heroin is almost 600,000 (HHS, 2016). There is, therefore, need to put in place policies and clinical practices that will reduce the occurrence of new cases of OUDs.

Results from the National Survey on Drug Use and Health in 2016 show that about 12.5% of those using illicit drugs started by using the nonmedical prescription of pain killers (Abuse, 2017). Those with dependence on pain relievers were approximately 1.9million, and these numbers have been increasing over the years. Over 12.5 million Americans of 12years and older have used opioids for other purposes that are not medical at least once in their lifetime. 40% of opioid overdose deaths were prescription related to opioid overdoses accounted for more than 42,000 deaths in 2016 (Hughes et al., 2016).

Deaths from opioid abuse have quadrupled from 1.4 to 5.1 deaths per 100,000 people 1999 and 2013 as shown by data presented by Chen, Hedegaard, and Warner (Chen et al., 2013). Evidence showed that 82.5% use of opioids came from written prescriptions in 2012 (Paulozzi et al., 2012).

Research done in different states in the US shows that states differed in legislation i.e., laws, rules, and regulations regarding prescription, oversight, and education requirements and reduction strategies related to opioid use. The states lacked a regulated system concerning the role of nurses in administering and prescribing opioid medication. States such as California, New Mexico, Oklahoma have complicated rules for practitioners and patients to decipher. Illinois and Montana have no particular policies that documented to help guide prescribers on how to address chronic pain by patients (Manasco et al., 2016).

Nursing Practitioners

Data from the Centre for Disease Control shows that there is inconsistency in what healthcare professionals know about their patients and what the patients are telling them. For example, Registered nurses (RNs) who responded on a survey said that 48% of patients inquire about opioids as a pain reliever and that 46% of patients use homeopathic remedies. In comparison, 64% of patients use prescription medicines. In contrast, only 30% of patients asked said they were using non-opioid drugs for pain relief, and, for 17% of them, homeopathic remedies were a method of choice.

On formal training, over 60% of RNs have undergone training to differentiate chronic pain and addiction in comparison to 43% of administrative staff. There are other challenges, such as only slightly over 4% of physicians in the US have undergone training to enable them to prescribe buprenorphine (MAT), and there are only about 3,600 physicians, board-certified in addiction medicine. These numbers affect a vast population that needs their services (Abuse, 2017).

Nursing Knowledge Gap

Nurses must be able to assess vital signs and overall health status of a patient to determine the best form of pain management to be used. They should receive in-depth education on opioid abuse and addiction and be allowed to consult in case of questionable circumstances or contradictory results.

The lack of proper nursing prescriber training and monitoring during the administration of opioids has a high impact on the abuse of the same. They need to be well and superbly equipped with proper clinical judgment when administering opioids for pain management using pain assessment instruments and taking the appropriate decision as per the patients' needs (Schiek et al., 2016).

Essential data and policies need to be made available for nurses to access in administering the proper treatment for patients with chronic pain as insufficient data affects the overall outcome. Another effect comes from the lack of proper communication among bedside nurses, prescribers, and other practitioners involved, which is vital and should be effective from the start of problematic signs by the patient concerned to reduce new and increased forms of addictions and abuse.

Education regarding opioid antagonists such as naloxone and others availed to make medicine-assisted treatment (MAT) useful and timely. Hindrance may occur due to a lack of clinical experience and knowledge. Inadequate knowledge about pain treatment, assessment, and alternatives also affects the healthcare system.

Another issue is a lack of research on current evidence-based practice approaches to pain management by the nursing practitioners that could enable the use of other non-opioid remedies and not be quick to settle on opioids. Institutional commitment and involvement of all caregivers concerned are necessary as this will ensure proper policies and guidelines are put in place and followed. The Nursing curricula that include nursing students need to include pain management tests, assessments, and alternatives as well as practical assignments for the experience. Through this and continued learning, the intervention of abuse cases can quickly reduce. Lack of using evidence-based guidelines has is observed, and this further increases the pandemic, which needs to be under control. (Barry et al., 2016)

There is a need for education on the use of non-opioid strategies such as physical therapy, psychological therapies, and non-opioid analgesics to increase efficiency and safe care and reduce abuse. Ways to handle requests for pain medication, inadequate pain relief and unruly behaviors by patients need to address to avoid harm.

Guidelines set by the Centre for Disease Control (CDC) in administering patient-centered clinical practices, need to be followed. These include conducting thorough assessments, considering all possible treatments, closely monitoring risks, and safely discontinuing opioids in addition to evaluating the risk involved.

Conclusion

Research on how to manage pain through improved training access to treatment for those suffering from chronic pain should be prioritized. Healthcare professionals need more training on how to pinpoint potential addictions, differentiate chronic pain and addiction and understand the treatment methods currently in use. Therefore, prescription monitoring methods should be in place. Policy changes and consistent application of laws about opioid use are to be put in place to avoid deaths and other injuries. New techniques to address both physical and psychological can effectively reduce the chances of addiction and abuse. Focus on the patient overall concerning physical and mental health will also ease the occurrence of injury since they are both interrelated.

Nursing practitioners should be well informed and equipped to deal with opioid abuse through proper educational programs put in place and standardized prescription methods for consistency and easy monitoring. Research methods need to be improved and implemented at the state level with adequate funding provided. Food and Drug Administration (FDA) has to come up with ways to combat abuse by making opioids analgesics tamper-proof and not easy to damage. Specific measures need to be in place. For example, provide education and prescription guidelines, restricting supply by regulating products approved and their access, educating patients about opioids, increasing treatment for OUD, and giving necessary medicines to prevent overdose deaths and harm from the use of related substances. Trading down to cheaper black market opioids as a result of addiction and inability to financially sustain access has led to mortality rates increase from overdose or suicide. Injecting drugs as a way of ingesting psychoactive substances increases health risks of contracting diseases such as hepatitis C virus, HIV, and AIDS.

References

Barry, C. L., Epstein, A. J., Fiellin, D. A., Fraenkel, L., & Busch, S. H. (2016). Estimating demand for primary carebased treatment for substance and alcohol use disorders. Addiction, 111(8), 1376-1384.

Abuse, S. (2017). Mental Health Services Administration. Key substance use and mental health indicators in the United States: Results from the 2016 National Survey on Drug Use and Health (HHS Publication No. SMA 17-5044, NSDUH Series H-52). Rockville, MD: Center for Behavioral Health Statistics and Quality. Substance Abuse and Mental Health Services Administration.

Chen, L. H., Hedegaard, H., & Warner, M. (2015). Rates of deaths from drug poisoning and drug poisoning involving opioid analgesi...