Numerous discussions about the rise of the opioid crisis are developed to understand its positive and negative outcomes. Opioid misuse is a serious public health concern that requires immediate solutions (Volkow & Collins, 2017). It is not enough to identify the problem and use statistics to prove its urgency. Modern scientists and healthcare employees are involved in continuous research to create prevention interventions, reduce mortality, and introduce effective alternatives.
As well as any healthcare issue, the opioid crisis has its pros and cons. In this paper, both aspects of the topic will be covered to explain why using opioids as a means to control patient pain has to be reduced. The increased prescription of opioid medications was a popular recommendation several years ago until addiction and misuse were proved to be hardly controlled (The U.S. Department of Health and Human Services, 2019). Patient suffering is an urgent issue for all medical workers, and compassion or trust is used to explain the choice of opioids in care. It is high time to consider new methods of pain control and recognize the threats of the opioid epidemic for American in- and outpatients.
Current Status of the Issue
The spread of epidemics is not always easy to control because they suddenly emerge and touch upon millions of people. However, if disease epidemics have specific symptoms and are characterized by effective epidemiological studies, the opioid epidemic is quiet and hardly recognizable as it is also a method to treat patients (Bryant & Forman, 2019). Nurses and doctors choose opioids when they cannot find out other quick and effective methods to reduce pain and help patients relieve their suffering. According to the Centers for Disease Control and Prevention (2018), in the United States, about 700,000 people died from a drug overdose in the period between 1999 and 2017.
Regarding the current status of the issue, approximately 68% of overdose cases involved an opioid in 2017. The most frequent explanations of why deaths occur include the prescription of pain relievers, the misuse of synthetic opioids, and the addition to heroin (The National Institute on Drug Abuse, 2020). In other words, instead of investigating the effects of opioids on humans when they are assigned, attention is paid to the general condition of an individual and the possibility to reduce negative symptoms.
The intention to choose the best pain management plan prevents an understanding of the existing threat of the issue. For example, in 2018, about 10.3 million people reported that they misused prescription of opioids, with only two million people doing it for the first time (The U.S. Department of Health and Human Sciences, 2019). It means that more than eight million people regularly misuse opioids, turning it to addiction.
Significance of Opioid Crisis
Many people find it normal and even obligatory to take medications in order to reduce pain, control the symptoms of their disease, and prevent the growth of complications. Unfortunately, opioid dependence turns out to be a dangerous outcome, and one of the potential causes of death among inpatients and outpatients. People think that they protect their health by using opioids, but they also misuse medications. Therefore, the American Nurses Association (2018) aims at identifying patients who, by chance, could contribute to the opioid epidemic and the development of substance use disorders. Signs and symptoms could vary among patients, and this problem may be asymptomatic for some period.
The significance of the chosen issues is explained by the presence of several waves in opioid-related deaths. The Centers for Disease Control and Prevention (2018) identified the first wave in the 1990s (semi-synthetic drugs and methadone), the second wave in 2010 (heroin), and the third wave in 2013 (illicitly-manufactured fentanyl). These cases prove that even the interventions to predict the problem and control medication misuse cannot be 100% effective in preventing the opioid crisis.
Potential Impact on Healthcare and Nursing
In addition to the mentioned reasons for choosing the issue of the opioid crisis for discussion, its impact has to be discussed from the point of view of health and nursing care. Patients could blame the system and the way health care is offered to them as the main cause of addiction. However, Dasgupta, Beletsky, and Ciccarone (2018) admit that it is usually a personal (individual) decision to start opioid use (e.g., heroin), not the result of a misused prescription.
People find it unusual but interesting to try drugs and discover some new effects of opioids on their lives. Nurses have to understand that their responsibilities include drug prescription control, as well as the improvement of the level of knowledge and citizens’ awareness about the risks of drugs in their lives. Another crucial impact of the chosen issue is the necessity to solve the problem and introduce the ways of how to reduce the number of deaths because of opioid misuse. Nurses and healthcare workers should investigate cases, compare the results, and conclude what precautions are effective. Epidemic numbers are the stimulus for them to take action and implement change.
Pros and Cons of Opioid Use
Nowadays, people have access to a variety of opioid drugs, including methadone, oxycodone, morphine, naloxone, and meperidine. Many of them are used as a part of a medication-assisted treatment plan. Their benefits are pain relief, drug addiction control, and flexible dosing (Pitt, Humphreys, & Brandeau, 2018). In addition, opioids are frequently prescribed to treat chronic pain as they combine receptors in the brain and other areas in the body and tell that no pain is experienced. In the majority of cases, opioids are introduced as safe substances in case they are prescribed by a professional (licensed) medical worker. To avoid negative outcomes, patients (either those who are treated in hospitals or continue their treatment at home) should not change opioids and report if any question or physiological or psychological effect is observed.
There are situations when patients are transported to emergency departments with traumas and uncontrolled pain as chief complaints. Opioid analgesics are prescribed to help patients stabilize and share their personal information or other details. Many studies support the idea of short-term opioid therapy if it is offered as first-line therapy after the examination does not reveal any negative drug history (Lembke, Humphreys, & Newmark, 2016).
The possibility of benefits from opioids also depends on the quality and the nature of pain. For example, Huber, Robinson, Noe, and Van Ness (2016) state that patients with osteoarthritis pain or diabetic neuropathy use opioid treatment to succeed in controlling such types of chronic pain. Such therapy is effective for patients with low risk of drug abuse or individuals who fail non-opioid treatment interventions.
In other cases, the use of opioids can have a dangerous outcome for people because of a variety of reasons. The most evident shortages of opioids are dependence and addiction (The National Institute on Drug Abuse, 2020). Many doctors choose opioids for postsurgical patients to reduce the level of pain and provide them with care and support for the required period. However, sometimes, ineffective pain management may result from excessive use of opioids and lead to serious complications and long-term hospitalization (Kwan & Sullivan, 2018).
It happens when patients receive more than necessary opioids for home use, fail an education process, and cannot understand the line between the desired and allowed amount of medications. To avoid complications, medical scientists continue developing new methods to overcome the prescription of narcotics like the combination of acetaminophen and ibuprofen (Kwan & Sullivan, 2018). High-tech treatments, including the use of radio waves, herbal therapies, and acupuncture are frequently recommended options to control pain in patients either in hospitals or at home.
Con Position and Rationale
The offered statistics, the inability to control the use of narcotics outside, and the existing cons and pros of opioid therapy prove the ambiguity of the chosen issue. Still, taking into consideration this data, my position as an Acute Care Adult and Gerontology Nurse Practitioner is against the use of opioids in patient care. It is not just a personal point of view that lacks evidence and external opinions. Recent observations in Canadian and American health care show the connection between overprescription and opioid analgetic consumption, which leads to unrealistic expectations about the worth of drugs (Dasgupta et al., 2018).
The Centers for Disease Control and Prevention (2018) and the American Nurses Association (2018) also admit that the opioid epidemic is dangerous for people due to the number of deaths and associated opioid use disorders. Healthcare providers may give an opioid prescription with the only purpose to reduce pain. At the same time, they inform that such side effects like dizziness, nausea, vomiting, constipation, and respiratory depression can be observed (Huber et al., 2016). Therefore, the question about the effectiveness of narcotics in pain relief remains open today.
My doubts about the use of narcotics in pain management are also connected with the intention to develop new methods and therapies to remove this type of treatment for patients. It means that scientists and medical workers are not satisfied with the quality of opioid work and want to find out something less harmful. Kwan and Sullivan (2018) promote the use of ibuprofen in combination with other non-opioids, discussing their financial aspects and the possibility of saving money. Opioids are costly either for inpatients or outpatients, and the price of ibuprofen is constant ($15.96 per dose) (Kwan & Sullivan, 2018).
Many older adults could get an opportunity to control their savings and healthcare services. My work in the area of gerontology shows that some patients do not have enough knowledge about opioids and its effects on human health. As soon as they see that the drug could remove pain at least for a moment, they like to take it. Opioid misuse is one of the urgent public health problems in America, and nurses have to give clear explanations of the line between opioids for pain relief and heroin as addiction.
Nursing professional organizations have to pay attention to the conditions under which narcotics are prescribed as a part of treatment to relieve pain. About 11%-40% of the US population report ongoing chronic pain as their chief complaint and agree to use opioids. Therefore, the American Nurses Association (2018) involves the government and law-makers in the discussion of this issue to avoid opioid dependence but ensure the interests of nurses in helping their patients.
The Centers for Disease Control and Prevention (2018) fight the opioid overdose by collecting data and providing care to at-risk communities. Their interventions include education of patients, the introduction of medical alternatives, and the provision of healthcare facilities with necessary tools and guidance. As soon as nurses start learning different aspects of the opioid epidemic, they can share this information with the population and predict narcotics-related problems.
In general, it is always easy to offer a patient an opioid medication and promise to reduce pain within a short period. Many nurses and doctors cannot deal with their feelings and compassion for patients who beg their help and immediate action to improve the situation. The opioid epidemic is hard to control because overprescription and misuse are frequently reported by many individuals and facilities.
Sometimes, people do not understand when they cross the line between using opioids as a treatment part and addiction. Therefore, nurses, as well as other medical staff, have to improve their knowledge, learn statistics, and contribute to the prevention of narcotic dependence. In addition to public awareness, the development of new methods of treatment for patients who are in pain signalize about the negative outcomes of opioids. Much time and effort are spent to introduce new interventions, and if the government supports healthcare and nursing associations in their purpose to protect the population against the opioid epidemic.
The American Nurses Association. (2018). The opioid epidemic: The evolving role of nursing. Web.
Bryant, R. L., & Forman, H. L. (2019). Prescription drug abuse. Santa Barbara, CA: ABC-CLIO.
The Centers for Disease Control and Prevention. (2018). Understanding the epidemic. Web.
Dasgupta, N., Beletsky, L., & Ciccarone, D. (2018). Opioid crisis: No easy fix to its social and economic determinants. American Journal of Public Health, 108(2), 182–186. Web.
Huber, E., Robinson, R. C., Noe, C. E., & Van Ness, O. (2016). Who benefits from chronic opioid therapy? Rethinking the question of opioid misuse risk. Healthcare, 4(2). Web.
Kwan, T. M., & Sullivan, M. (2017). The use of intravenous ibuprofen and intravenous acetaminophen in surgical patients and the effect on opioid reduction. Medsurg Nursing, 26(2), 124-142.
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Volkow, N. D., & Collins, F. S. (2017). The role of science in addressing the opioid crisis. New England Journal of Medicine, 377(4), 391-394.