Chronic pain is an important public health problem that negatively impacts the quality of life of affected individuals and exacts a tremendous cost in both healthcare costs and lost productivity. The Institute of Medicine (IOM) in its landmark report on relieving pain in American estimated that 100 million individuals suffer from chronic pain at a socio-economic cost of between $560 and $635 billion annually [IOM, 2011]. Opioids have been increasingly prescribed for the management of chronic pain, and along with this increase in use has come an increase in opioid misuse and abuse. Of the opioids that are abused, 60% are obtained directly or indirectly through a physician’s prescription. According to the Centers for Disease Control and Prevention …show more content…
Pain is one of the most common reasons people consult a physician, yet it is frequently inappropriately treated [St Stauver JL, 2013]. To deal with this dilemma, nurse practitioners can play an important role on the pain care team, particularly as primary care clinicians spend less time with patients and are increasingly reluctant to provide care for pain patients. As frontline providers, they can take the time to perform a thorough patient assessment and physical examination and follow through with pain treatment, while also playing an essential role in patient education and assessing and monitoring the patient’s opioid risk. Their primary goal is to develop a therapeutic relationship with patients, providing the time and space for patients to tell their pain story [Hughes, 2013], which they then can communicate to the rest of the team and which forms the basis for all subsequent decisions about treatment. The paragraphs below describe the predominant clinical practice gaps in current management of chronic pain. As NPs increase their knowledge and competence in these areas, it is anticipated that changes in clinical practice will
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
The aim of this review is to examine what is the most appropriate method of pain assessment and management when working with clients with cognitive impairment.
One thing contributing to the high usage of opiates is their ability to have strong pain relieving effects. The availability of prescription medications containing opium contributed to the misuse and abuse of the substance as well (Chen, Humphreys, & Shah, 2013, p. 60). Since opiates were easy to possess from medical personnel, it became clear that it was contributing to issues related to the misuse and abuse of opiates (Chen, Humphreys, & Shah, 2013, p. 60). Therefore, over the past few years, prescription drugs which possessed addictive qualities such as opioids, has been closely monitored to avoid nonmedical usage (Chen, Humphreys, & Shah, 2013, p. 60). Nonmedical prescription drug use and disorders are pervasive in the U.S. population, it also tends to be highly comorbid with other psychiatric disorders (Huang, et al., 2006, p.
Herr, K., Titler, M., Fine, P. G., Sanders, S., Cavanaugh, J. E., Swegle, J., Forcucci, C. (2012) mentioned some of the challenges commonly faced regarding pain management, these include: misconceptions about pain, evaluating pain in those who have cognitive impairments, those with multiple co-morbidities, polypharmacy issues and those who are reluctant to take opioids analgesics. It has been noticed that the problem involves lack of application of Evidenced Based Practice (EBP) for pain by nurses and physicians. The reason for conducting this research is to report on the results of a Translating Research Into Practice (TRIP) intervention, that includes strategies designed to promote adoption of
As we all have researched and found out the devastating numbers to the opioid epidemic “the abuse of prescription and non-prescription opioids is one of the greatest threats facing public health in the United States today. It is estimated that as many as 2.5 million people in the US are suffering from opioid addiction related to prescriptions, and an additional 467,000 are addicted to heroin”(2017).
"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."
Doctors and clinical prescribers have discovered their role in curtailing the increased opioid prescriptions in America. It is without a doubt that they play a role in facilitating the opioid misuse endemic in the past by being enablers of the situations. When patients ask for pain medications, they do not take time to analyze the pain complaints or suggest alternative medications other than opioids. Even in instances when one doctor declines to offer a patient an opioid prescription for their pain needs, the patient is likely to find another who will give the prescription. However, there has been wide recognition of the opioid misuse endemic such that clinical prescribers are practicing more vigilant prescribing and are advocating opioid-free
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
The first step of this model is to create a sense of urgency and to get the nurses motivated to change (Kotter, 1995). By explaining that data from the last quarter demonstrated an increase in rates of worsening pain, will communicate the “why now” of the QIP to the nurses. Additional education about the responsibility and accountability nurses have in accurately assessing, managing and documenting pain will assist in
The United States of America has had a war against drugs since the 37th president, Richard Nixon, declared more crimination on drug abuse in June 1971. From mid-1990s to today, a crisis challenges the health department and government on opioid regulation, as millions of Americans die due overdoses of painkillers. Opioids are substances used as painkillers, and they range from prescription medications to the illegal drug, heroin. Abusing these substances can cause a dependency or addiction, which can lead to overdoses, physical damages, emotional trauma, and death. To ease the crisis, physicians are asked to depend on alternatives to pain management. Law enforcement cracks down on profiting drug-dealers and heroin abusers. People are warned against misusing opioids. The controversy begins for those who suffer from chronic pain, because they depend on opioids. There’s so a correlation to the 1980s cocaine epidemic, and people are upset over racial discrimination. Nonetheless, the best way to avoid this crisis is to recover the people at risk, reduce inappropriate opioid description, and have a proper response.
The United States currently faces an unprecedented epidemic of opioid addiction. This includes painkillers, heroin, and other drugs made from the same base chemical. In the couple of years, approximately one out of twenty Americans reported misuse or abuse of prescriptions painkillers. Heroin abuse and overdoses are on the rise and are the leading cause of injury deaths, surpassing car accidents and gun shots. The current problem differs from the opioid addiction outbreaks of the past in that it is also predominant in the middle and affluent classes. Ultimately, anyone can be fighting a battle with addiction and it is important for family members and loved ones to know the signs. The cause for this epidemic is that the current spike of opioid abuse can be traced to two decades of increased prescription rates for painkillers by well-meaning physicians.
Prior to 2000, nurses would routinely monitor a patient’s blood pressure, pulse, respirations and temperature: the four vital signs. After 2000, the Joint Commission on Accreditation of Healthcare Organizations added pain as the fifth vital sign and nurses were required to evaluate a patient’s pain level using a numeric scale of 0 to 10 (Florida Office of the Attorney General, 2012). This led to a flood of opioid based pain relievers hitting the market and an increase in physicians writing prescriptions for these medications. Previously opioids had been used for treatment of cancer related pain, but broadened to include management of chronic non cancer pain (Edlund, et al., 2014). Research by Edlund
The study conducted by Stanley and Pollard (2013) had two components. The first was to assess the amount knowledge concerning pediatric pain management of nurses then gauge their attitudes and level of self-efficacy concerning acute pediatric pain care. The second was an examination of the relationship between years of experience, amount of knowledge, attitude, and levels of self-efficacy. According to the authors, studies have previously indicated that care may be affected by the level of knowledge and attitude of the nurse, however no research existed between each component and self-efficacy. Stanley and Pollard predicted that a nurses job performance concerning adequate pain management of pediatric patients would be affected by the two components examined. (Review of literature ) They presented the problem by citing previously conducted peer-reviewed studies indicating that proper pain management of pediatric patients was lacking and which emphasized the importance of knowledge of the topic [cite]. Examples were given of barriers to proper pain management which included: ignoring patient self-report, lack of education about pain assessment, misunderstanding pharmacological effect on the respiratory system, lack of a universally applied pain management system, work security concerns, perceived inferiority, and time constraints. ( Stanley et al., 2013)
Provision of pain relief is a shared responsibility of the interdisciplinary health care team. For example it may initially form part of the oncologist’s remit to determine the most effective pain management plan for the patient. After treatment has been initiated, oncology nurses may then adopt responsibility for ensuring that pain relief is adequate via regular assessment and action (NICE, 2004, p.80).
While our major access to these drugs is doctors, we cannot simply lay blame on them, as there is not enough knowledge about these treatments to correctly appropriate drugs, and therefore extra is given (Hemphill 373). Alexander of the Department of Epidemiology of the Journal of the American Medical Association, states that “There are serious gaps in the knowledge base regarding opioid use for other chronic nonmalignant pain” (Alexander 1865-1866), which leads to the unfortunately large number of leftover drugs. In fact, the main place that people get their drugs are from leftover prescriptions (Hemphill 373).