Opioid-Induced Side Analysis

Mike Alstott knows first-hand how opioids, when used correctly, can play an important role in managing pain and helping people to function, but he is also keenly aware of the growing crisis of opioid misuse and overdose. More American adults are dying from misusing prescription narcotics than ever before. An estimated 35 people die every day in the U.S. from accidental prescription painkiller overdoses resulting from things like not taking a medication as directed or not understanding how multiple

According to surveys, up to 80% of patients reported moderate to severe post-surgical pain, which can sometimes be left undertreated (Sinatra et al., 2005). Postoperative pain is generally managed with opioids, which carry numerous side effects. Side effects can be bothersome and possibly cause a delay in the postoperative healing process (Beard, Leslie, & Nemeth, 2011). IV acetaminophen can possibly decrease opioid consumption, minimize side effects, increase patient satisfaction, and decrease costs (Wininger et al., 2010). The purpose of this paper is to dive further into the research to present data on the effectiveness of IV acetaminophen in decreasing opioid usage and whether it produces an additive effect causing more effective pain management in the postop patient.

Opioids are commonly used in the intensive care unit (ICU) to control painful conditions and overall to alleviate the intensity of pain. Clinical uses of opioids has been occurring for thousands of years and includes pain relief of acute pain post surgery, injury or trauma, cancer pain and pain from chronic and disabling diseases. Two conventional opioids used in the ICU are morphine and fentanyl. Although both are used, one appears to have greater benefits through patient outcomes and lower costs with that being fentanyl as the preferred opioid in the ICU in both adults and children. Yet, morphine and fentanyl are still being used interchangeably in the ICU. It is uncertain whether physicians know that costs are decreased and adverse reactions

As better and more comprehensive education is provided both to the general public and practicing clinicians the hope is to reduce the negativity surrounding the users of opioids, and to eliminate demeaning language coupled to them as well. This could improve patient morale and help the needless continuation of physical suffering within patients, as they would be more comfortable approaching and using opioids for therapeutic purposes1. That being said there are those within our communities who do abuse these substances and pharmacists must recognize the signs of abusers, it is important for them to reach out, without comment, to help those suffering from opioid abuse once they have been

But for most conditions, there is little evidence that opioid-based treatment is more effective than other options (Pho 8). For back pain, migraines, and pain related to surgery, there are many alternative treatments such as physical therapy or anti-inflammatory drugs (“Safer Alternatives” 3). This is due to the fact that opioids are easier to prescribe or even because their patients demand them (“Safer Alternatives” 3). Unfortunately, it is also because insurance plans don’t always cover alternative treatments that may help the patient (“Safer Alternatives” 4). This can lead to patients getting addicted to opioids for something that could have been easily treated using an alternative treatment. In some cases, the doctors may be susceptible to bribes. For example, six executives from Insys

Considerable cautions have been obtained throughout the United States to decrease the misuse of prescription opioids and helps to minimize opioid overdoses and related complications. Even though the pain medications have a significant part in the treatment of acute and chronic pain situations, it sometimes happen that the high dose prescription or the prescribed medications, without having enough monitoring, can create bad outcomes. It is always a dilemma for the providers to find who is really in need of pain medications and to identify those who are questionably misusing opioids.

The use of opioid-based prescription medications to treat non-terminal chronic pain can cause side effects from short term use, and is overly common and ineffective. Firstly, opioid usage can induce negative short-term effects. According to William A. Darity, Jr., short-term opioid usage causes negative effects such as “euphoria, drowsiness, and impaired motor and cognitive functioning” (“Drugs”). The short term effects of the opioids may cause the patient to isolate him or herself socially due to being self-conscious about his or her friends and peers seeing the individual in their current condition. Due to his or her fragile emotional state, however, if the patient isolates him or herself during a time in which he or she should have increased

Opioids are prescription drugs that deal with reducing pain when taken. There are various types of prescription drugs that can classify as opioids such as morphine, codeine, hydrocodone, or Demerol, to name a few. The drugs originally are synthesized and derived from the opium poppy, Physicians will prescribe this medication as a painkiller, but many others turned to purer doses of these medications and started turning to more potent drugs like heroin or Percocet. The one thing that these brand name drugs have in common is that they contain opium, an extremely addictive narcotic drug. In many cases, many patients receiving pain killing medication from doctors become dependent on the drug, leading them to use it recreationally instead

Roughly 100 million Americans suffer from chronic pain with an annual cost of $600 billion dollars in health care and a limited number of pain specialist physicians (Harle, et al., 2015). The conditions require the daily use of opioid medications which are being prescribed by primary care providers and providers in the ED. Along with multiple prescribers of opioid medications, the number of prescriptions for these medications has quadrupled from 1999-2013 in correlation with an increase in deaths related to opioid use (Greenwood-Ericksen, Poon, Nelson, Weiner, & Schuur, 2016). The significant increase of opioid related deaths and complications is commonly being referred to as the prescription opioid epidemic and to blame for the most unintentional deaths in the US (Smith, et al., 2015). Though responsible for administering and prescribing opioids to provide pain management, nurse practitioners in the ED have limited patient history and are placed under time constraints. Improved education regarding pain management, clinical practice guidelines and the use of resource tools like the Prescription Drug Monitoring Programs (PDMP) have been proven effective for reducing opioid related complications (Greenwood-Ericksen et al.,

The over use of opioid has been one of the major public health problem in the United States (Substance Abuse and Mental Health Services Administration, 2018). Opioids include prescription medications that are used to treat pain symptoms which includes codeine, morphine, methadone, hydrocodone, and etc., as well as illegal drugs such as heroin and illicit potent on opioids such as fentanyl analogs (Substance Abuse and Mental Health Services Administration, 2018). The opioid overdose could happen due to many factors such as when a patient deliberately misuses a prescription, or misuse heroin (Substance Abuse and Mental Health Services Administration, 2018). Opioid overdose could happen due to the prescriber miscalculated the opioid dose or when

Opioids are drugs that act on the nervous system to relieve pain. Using them continuously and abusing can lead to physical dependence and withdrawal symptoms. They come in different forms such as tablets, capsules and even liquid.

Article 11: Chronic pain is associated with impairment in sleep. The relationship between using prescribed opioids and sleep is unclear. The focus of the study was to examine differences in self-reported sleep quality between groups of patients who were different by chronic pain and prescribed opioid status. The use of opioids with chronic non-cancer pain continues to increase. Common adverse effects associated with the initiation of opioids including constipation, nausea, somnolence, and vomiting. Up to 50% of patients stop taking opioid therapy because of intolerance or insufficient pain relief. Research shows that pain often results in disruptions to sleep and impaired sleep itself a risk factor for pain. In a comprehensive review

Opioid drugs are some of the most widespread pain medications that we have in this country; indeed, the fact is that opioid analgesic prescriptions have increased by over 300% from 1999 to 2010 (Mitch 989). Consequently, the number of deaths from overdose increased from 4000 to 16,600 a year in the same time frame (Mitch 989). This fact becomes even more frightening when you think about today; the annual number of fatal drug overdoses in the Unites States now surpasses that of motor vehicle deaths (Alexander 1865). Even worse, overdose deaths caused by opioids specifically exceed those attributed to both cocaine and heroin combined (Alexander 1865).

Opioids are the most widely used and effective of analgesics for the treatment of severe pain. They act by binding to specific proteins called opioid receptors, which are found in the central nervous system. There are four known receptors mu, delta, kappa and opiate like receptor. The most common pain management receptor is the mu, it is also involved with mood enhancers and causes activation of dopamine that is associated with euphoria. When these drugs attach to their receptors, they drastically reduce the amount of pain. Opioids can also produce other effects such as, drowsiness, nausea, lowering of blood pressure and reducing respiration. Opioids can also produce a euphoric feeling for some users, as it is interferes with the reward pathways.

Together with the increasing number of years added to the older adults’ life, is the rise in the use of medications by the elderly. As discussed by Touhy and Jett (2016) “Medications occupy a central place in the lives of many older persons: cost, acceptability, interactions, untoward side effects, and the need to schedule medications appropriately all combine to create many difficulties” (p. 112). One health condition from which many older adults have in common is pain, “chronic pain affects approximately 100 million US adults and is one of the most prevalent symptoms among seniors, affecting older adults more than any other age group” (West & Dart, 2016, p. 539). Thus, the “prevalence of chronic pain in the USA has been accompanied by an upsurge of therapeutic opioid utilization” (West & Dart, 2016, p. 539). Due to slow metabolism that goes with aging, it has been proven that “older adults are more vulnerable to the adverse effects of pain medication. Older age is also associated with an increased prevalence of impaired cognitive function, putting these patients at additional risk of unfavorable drug exposure” (West & Dart, 2016, p. 539). In addition, the co-morbidities of the older adults, also contribute to the “increase in polypharmacy use, which in turn increases the risk of experiencing adverse drug interactions” (West & Dart, 2016, p. 539).