Multimodal Opioid Analysis

First of all the author provides a well know resource The World Health Organization. This Organization is a specialized agency of the United Nations who has been around for many years. It’s a well reliable facility which provides estimates of patients who obtain pain medication for chronic pain. The author also states that the drug is a stimulant that relieves severe pain and produces a highly addictive powerful feeling of well – being. (Berrettini, 2016)

The selected policy Essence of Care 2010: Benchmarks for the Prevention and Management of Pain, includes the latest benchmarks on the management of pain and its prevention. It presents up to date reviewed views, with the aim to deliver

Although addiction and overdose of opioids was not declared an epidemic by the Center for Disease Control and Prevention (CDC) until 2011, the beginning of the epidemic can be traced back as early as the 1980’s when attention in medical care began to turn toward pain management. By the early 2000’s the Joint Commission on Accreditation of Healthcare Organizations named pain “the fifth vital sign,” implying that pain is as important clinically as pulse rate, temperature, respiration rate, and blood pressure (Wilson, 2016). At the same time, there has been an emphasis change from patient wellness to patient satisfaction metrics. Non-steroidal anti-inflammatory drugs such as Advil, Aleve, or aspirin have raised safety their own safety concerns, contributing to increased use of opioids. The lack of patient access to and insurance coverage for chronic pain management specialists or alternative healing therapies also contributes to the opioid epidemic (Hawk,

Jamison RN, Serraillier J, Michna E. Assessment and treatment of abuse risk in Opioid prescribing for chronic pain. Pain Res Cl. 2011;2011:1-12. doi:10.1155/2011/941808.

Rates of opioid-related overdose have been rapidly increasing in the United States. From 2010-2015, overdose deaths attributed to the use of illicit opioids has increased by over 200% (1). In 2016, the number of opioid-related deaths reached 64,070, the highest number ever recorded in the nation’s history and anticipated to increase (2). While opioid-related overdose had been largely caused by prescription opioid misuse, the problem is increasingly due to heroin and other illicit opioid use (3, 4). Increasingly, illicitly-manufactured fentanyl (IMF), an opioid much stronger than heroin, has become an increasingly common additive pervasive in the supply in the United States and has contributed to the steep rise in opioid-related overdose (5-8).

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.

Opioid is the fastest addiction in Iowa. “These are not aspirin,” says Dale Woolery. You can’t mix these painkillers with any other pill or painkillers in fact. Opioid painkillers are 50 to 100 times stronger than any other painkiller, from prescription painkillers to illegal painkillers, which are a knockoff of Heroin. Opioid is in the class of most addicting and lethal pills.

I see that Julia Lurie is trying to blame lobbyists for the opioid epidemic by using a causal chain. She claims that lobbyists convince the politicians to not control the accessibility of opioids, which results in users being able to access the drugs more, thus making lobbyists responsible for the opioid epidemic. I completely disagree with that premise. Maybe the accessibility of opioids has contributed to the problem, but claiming that lobbyists have caused the epidemic is going too far. Just because someone has accessibility to drugs, does not mean they will abuse them. The doctors may supply the drugs, but the people receiving the drugs are the ones that decide whether to abuse

Another pro of opioid based painkillers is a faster recovery after surgery. Individuals that come out of surgery with long term pain can take Oxycodone, Hydrocodone, Diphenoxylate, Codeine, and Fentanyl just to name a few to help relieve their pain. Reducing

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

It is important for physicians to take into account the various outcomes that happen when prescribing pain medications. Aside from having the burdensome responsibility of relieving a patient’s pain, a physician could also be responsible for the possibility of negative outcomes like sickness and even death as a result of pain medications often prescribed. Because of the risks

According to the systematic review covered by Apfel, Turan, Souza, Pergolizzi & Hornuss, 2013 there is a significant reduction in postoperative nausea and vomiting and opioid use when using intravenous acetaminophen. The reviewers used Medline and Cochrane databases to conduct their search along with a hand search of abstracts to identify randomized-controlled trials using intravenous acetaminophen. The review was to determine if the acetaminophen was going to have a significant decline in nausea and vomiting following surgical procedures as

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

Multimodal intervention along with attentive care and patient participation is necessary to achieve a balance between analgesia and side effects. Assumptions to the conceptual framework must be identified to understand the specific relevance of the theory to pain

Engwall (2009) defined pain as a "symptom and a warning that something is wrong in an organism” (p 370). Rathmell et al., (2006) maintained that fear of uncontrolled pain can be a traumatic situation for a patient undergoing surgery. Moreover, Pellino, et al (2005) sustained that “pain is a multidimensional experience, consisting of not only physical stimuli but also psychological interpretations of pain” (p. 182). Alleviating peri-operative pain is traditionally achieved with the use of pharmacological interventions. analgesia can incur undesirable side-effects like drowsiness, nausea and vomiting. Controlling the pain by complimenting analgesics with the use of non-pharmacological interventions, might ameliorate patients’ response to pain with fewer resultant side-effects. Thus, the need to evaluate the effect of non-pharmacological measures such as music, relaxation, hypnosis and others is highly solicited in the evolving heath system (Pyati & Gan, 2007).