Opioid Prescription Medications

Opioid addiction is so prevalent in the healthcare system because of the countless number of hospital patients being treated for chronic pain. While opioid analgesics have beneficial painkilling properties, they also yield detrimental dependence and addiction. There is a legitimate need for the health care system to provide powerful medications because prolonged pain limits activities of daily living, work productivity, quality of life, etc. (Taylor, 2015). Patients need to receive appropriate pain treatment, however, opioids need to be prescribed after careful consideration of the benefits and risks.

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).

"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."

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

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.

Addressing the people exposed to opioids may reduce the number of people starting and continuing to abuse drugs in the long term. In addition to this suggestion, data found from 2006-2015, the duration of opioids increased by a third suggesting fewer patients choose to start using opioids for pain management, however, patients already on medication continue to do so. This is because once long term opioid users, even when taking their medication as directed by their doctor, eventually develop a tolerance to the drug. A tolerance to pain medication can cause patients to up their dose or take too many medications in a small time frame in order to alleviate the same amount of pain that a smaller dose would have fixed in the past. The risk of developing tolerance is an important conversation to have with a health care professional because in addiction to pain, patients go on to develop a physical dependence to the drug. Physically patients feel pain, illness, and other symptoms; in some cases they are unable to give up the drug. This is when their dependence is classified as an

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

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

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,

Opioid abuse, misuse and overdose is a problem in The United States. You can’t turn on the TV or read a newspaper without some mention of the epidemic. This issue has caused the practice of prescribing or taking narcotic pain medication to be looked at under a microscope. Patients are fearful to use some necessary pain medication, because they may become addicted. Other patients who genuinely do have pain and need medication are having a tougher time obtaining the help they need. The problem of abuse and addiction is tough to solve since for some people the medications are the only way they can function and live a semi-normal life. A patient with pain may be hesitant to visit the doctor and

Opioid addiction is a condition that is preventable as well as one which individuals display several noticeable risk factors before the actual addiction prognosis to the point of causing death. There is a strong correlation between the early misuse of prescription opioids, which are prescribed for non-cancer pain management, and the development of a dependence on such opioids. Early detection of risk factors such as the misuse of opioids that are prescribed will help indicate that a patient is developing an addiction.1 Physicians, nurses, pharmacists, and other healthcare providers must closely monitor patients and the rate at which opioids are consumed as well as refilled.

While, CURES helps to identify red flags, there are no guidelines for pharmacists to ultimately make the final decision to fill an opioid prescription or not. CVS though, is making substantial changes to its pharmacy program. If a patient has a prescription for several weeks’ worth of an opioid and wants to fill that prescription for more than seven days, pre-authorization will be required and the drugs will have to be paid for out of pocket. CVS pharmacists will begin providing patients with thorough explanations as to why some of their opioid prescriptions won’t be filled. They will also be sure to counsel patients on the dangers of opioid dependence and addiction. As mentioned in Time, Dr. Steve Stanos, president of The American Academy

Living with pain is a daily struggle for many among us. We as a society push our bodies past the breaking point and live to tell the tale through opioid pain relievers. What did the many generations before opioids were created do, how was the pain relieved? That’s easy enough to answer they lived with it, or they didn’t. Medical and pharmaceutical interventions have come a long way in the treatment and management of pain, so much so that now we have run into another problem, the epidemic of opioid addiction and abuse. Out of this problem a far greater problem is being seen and that is the health risks associated with any drug used in a recreational form.

“Amid Opioid Crisis, Insurers Restrict Pricey, Less Addictive Painkillers” by Katie Thomas & Charles Ornstein

Lastly, the impacts of a family’s opinion and beliefs can make a huge impact on the type of pain management provided to the patient. For example, Reynolds et al. discuss how families may fear drug addiction for their loved one, along with belief that pain is a natural part of death and illness and potentially increases the progression of disease (2013). These misconceptions are merely a few of the roles families can play in regards to appropriate pain and symptoms management. With all these misconceptions, it is so significant that we can confidently provide families with the appropriate knowledge and information they need about proper opioid use so that families can gain a better understanding as to why we do what we do. Provide