Opioid Pain Assessment

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

As we see the further progression of the opioid epidemic within the United States, pharmacists become the frontlines to recognizing and providing care for these patients. It is however difficult to provide care for a patient when even the professionals within the medical community have an associated stigma attached to the use of these drugs. Patients who have a need for these painkillers recognize this stigma, and by doing so decide to avoid consulting their doctors and do not seek the care which they need. They do this to avoid the discriminatory treatment they receive both within and on the outside of the healthcare system, and to avoid the legal repercussions associated with the misuse and abuse of these products1. It is therefore the pharmacists' job to avoid the stigmatization of these people and respect those who use these treatments for legitimate medical purposes.

"If we could sniff or swallow something that would, for five or six hours each day, abolish our solitude as individuals, atone us with our fellows in a glowing exaltation of affection and make life in all its aspects seem not only worth living, but divinely beautiful and significant, and if this heavenly, world-transfiguring drug were of such a kind that we could wake up next morning with a clear head and an undamaged constitution - then, it seems to me, all our problems (and not merely the one small problem of discovering a novel pleasure) would be wholly solved and earth would become paradise."

This essay will aim to look at the main principles of cancer pain management on an acute medical ward in a hospital setting. My rational for choosing to look at this is to expend my knowledge of the chosen area. Within this pieces of work I will look to include physiological, psychological and sociological aspects of pain management.

Opioid abuse is a growing epidemic within the United States. Not only are people abusing the prescription forms of opioids (such as oxycodone - OxyContin, hydrocodone - Vicodin, codeine, and morphine) by taking more than they are supposed to, but they are also being bought, sold, and used on the streets illegally; such as heroin. Opioids are highly addicting because of the high they can induce in a person, causing a dependence and yearning for continued use (NIDA, n.d.) In 2007, the United States was responsible for over 99 percent of the global consumption of hydrocodone and 83 percent of the global consumption of oxycodone (United Nations Publications, 2009).

This article is about the cost of prescription opioid being abused, dependent on and being misused by individuals in the United States. The authors believed that the cost of prescription opioid abuse has become a burden for the United States as a society. Furthermore, the authors believe that the realms of health care, criminal justice and lost workplace productivity are faced with the most challenges of the burden caused by opioid abuse (Birnbaum, White, Schiller, Waldman, Cleveland, & Roland, 2011). The authors assumed to lessen the economic burden of prescription opioid abuse, there is a continuous need of effort from academic researchers, industry, health care providers, and government to implement appropriate actions (Birnbaum, White et

Opiates and opioids are narcotic pain medications that are highly addictive and deadly. Although these two drugs are nearly identical, there is one major difference that sets them apart from each other; Opiates are drugs that are obtained through opium, while opioids are drugs that are created synthetically, and are used to parallel the effects and key characteristics of that of opium (George F. Koob, Michael A. Arends, & Michel Le Moal, 2014).

The opioid epidemic is a problem of importance to me, with an immense national impact. As an adolescent in Chicago, I am exposed to the horrifying statistics of opioid abuse every day. For example, the CDC reports that 91 Americans die from opioid overdose every day and the number is quickly rising. Also, the amount of Americans have died from the "opioid war" is more than 3 times the U.S Military deaths during the Vietnam War. I have watched the stories of babies born with opioid addiction, teenagers in rural parts of Milwaukee and Ohio dying from overdosing and families being torn apart because of drugs like heroin, Percocet, and opium. There are people who believe that only poor and low-income individuals succumb to opioid addictions because you have to be uneducated to be exposed to drugs. But the truth of the matter is, opioids do not discriminate.

Modern day America is plagued by a surplus of tragedy, most may have seen viral videos of these “zombies” slumped in cars or streets and yet it continues. In fact, this terrifying epidemic was created by drugs that were intended for pain relief, Opioids. This includes prescription pain relievers like oxycodone, morphine, methadone, and hydrocodone. Ironically, the well-known street drug, Heroin, is one of the most serious offenders of the Opioid crisis (Anderson). With each day, more mothers, fathers, sisters, and brothers are witnessing and losing loved ones from overdoses, which is why the focus of society absolutely needs to be on a path of action towards the rising deaths, excessive prescriptions and governmental influences in opioid addiction.

Study shows that around 25% of adult patients experience severe and moderate pain that leads them to request medication such as opioid. Health Care Professionals (HCPs) sometimes has difficulty to offer other options in treating pain. HCPs had to assess patients and can only rely on the information provided by patients such as its side effects. If opioid is commonly prescribed for uncontrolled pain, how can HCPs assure it is use in a timely manner, or only as prn, and even to avoid misuse or abuse?

The opioids produce analgesic effects no matter is endogenous or synthetic, including morphine, codeine and methadone. (3)Endogenous opioid peptides such as endorphins, enkephalins and dynorphins activate opioid receptors including mu-receptors (mainly), delta-receptors, kappa-receptors and ORL1 receptors to produce different effects. One of the non-analgesic effects is the disruption of sleep-wake behaviour by the opioids’ actions on the ventrolateral preoptic nucleus (VLPO). The differences of the pharmacokinetic properties between the 3 opioids mentioned and the possible mechanisms of sleep-wake regulations will be discussed below.

At first it seems difficult to understand why hospitalized patients’ pain is not well controlled. After all, nurses want to relieve suffering – to do good without causing harm and to treat each individual justly without

Trossman (2006) states that at least 50% of patients are suffering from moderate to severe pain at their time of death, that 70 million Americans experience pain throughout their activities of daily living and that nurses hold the keys to pain management. According to Abdalrahim et al. (2010) there have been countless evidence-based studies regarding pain management; nevertheless, the inability to control the patients’ pain has increased due to nurses often devaluing the information they receive from the patients about their current pain level, these actions are directly related to a withholding of

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

Also the findings can be a baseline for future research in getting effective health intervention that can help in developing a nursing research. Pain is now the considered as part of vital signs in most hospitals, therefore we need an effective nursing model for pain. The concept of pain is an essential part of healthcare. Most elderly feel significant pain complications secondary to arthritis (Walker el al., 1990). In order to successful cope with continuing pain felt by elderly population, their perception of pain and the managing approaches used need to be assumed (Jensen el al.,