Pain Management: No Encumbrance In Health Care

Chronic non-cancer pain is a condition that need different alternatives in order to be treated while some patients could respond efficiently to some medications some others not. Nevertheless, in the market there are available enough options that offer a variety of strategies to treat pain, including opioids. Conversely, in the last years an increase in the abuse of pain reliever drugs containing opioids has increased alarmingly some specialist have termed it as “opioid abuse epidemic”.

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.

‘Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage’ (International association for the study of pain 2014). Pain can be made up of complex and subjective experiences. The experience of pain is highly personal and private, and can not be directly observed or measured from one person to the next (Mac Lellan 2006). According to the agency for health care policy and research 1992, an individuals self-report of pain is the most reliable indicator of its presence. This is also supported by Mc Caffery’s definition in 1972, when he said ‘Pain is whatever the experiencing patient says it is, existing whenever he says it does’.

The use of opioid-based prescription medications to treat non-terminal chronic pain can cause side effects from short term use, and is overly common and ineffective. Firstly, opioid usage can induce negative short-term effects. According to William A. Darity, Jr., short-term opioid usage causes negative effects such as “euphoria, drowsiness, and impaired motor and cognitive functioning” (“Drugs”). The short term effects of the opioids may cause the patient to isolate him or herself socially due to being self-conscious about his or her friends and peers seeing the individual in their current condition. Due to his or her fragile emotional state, however, if the patient isolates him or herself during a time in which he or she should have increased

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

Opioids, otherwise known as prescription pain medication, are used to treat acute and chronic pain. They are the most powerful pain relievers known. When taken as directed they can be safe and effective at managing pain, however, opioids can be highly addictive. Ease of access helps people get pain medications through their physician or by having friends and family get the medication for them. With their ease of access and being highly addictive the use and misuse of opioids have become a growing epidemic. Patients should be well educated on the affects opioid use can have. More importantly instead of the use of opioids, physicians should look into alternative solutions for pain management. While pain medication is helpful with chronic pain, it is also highly addictive, doctors should be more stringent to whom and how often they prescribe pain medication.

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.

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

In the United States, opioids have become a major component in healthcare because they are an exceptional method of relieving pain. For those who are recovering from a recent inpatient surgery or those with cancer who are in a great deal of pain, it is a necessity. A known problem with opioids is that they are addictive, which leads to overuse of the medication by the patient. Opioids are also highly sought after as a street drug, this leads to patients exaggerating their pain level in order to receive more pills and selling their excess medication to others. Doctors will often prescribe opioids to patients who do not need such an aggressive form of pain relief, for example, people with arthritis or who have gone through a minor outpatient surgery. This can lead to a long-term use of these pain relieving drugs and possible addiction, which goes against the original purpose of opioids. In order to solve America’s dependence on opioids, medical professionals must go back to the original method of prescribing them, that is, only short-term use for people recovering from surgeries or in pain due to cancer, instead of a long-term solution for acute pain.

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.

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 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.

Mandated limits on opioid prescriptions for acute pain offers the promise of advancing the safe use of these medications in two ways. First, it will reduce the exposure of first time users to these addictive substances following episodes of acute pain. For some patients who come to misuse opioids, the euphoria or sedating effects of these medications are initially experienced in the context of routine medical care. There are countless anecdotes of patients who take opioids for a minor orthopedic injury or some other acute pain condition and then go on to use prescription opioids non-medically. A recent population-based study suggested that 6% of incident opioid users progress to long-term use.4 Another study found that patients who received opioids following minor surgery were 44% more likely to become long-term opioid users compared to those who did not.5 Decreasing the initial amount dispensed may potentially lessen the risk that patients develop an affinity for these drugs and transition to chronic use or misuse.

Painkillers are the most common treatment option for chronic pain. However, the painkillers that are usually prescribed to patients are opioids. One of the major side effects of opioids is addiction. Canada is currently suffering from an opioid crisis because doctors didn’t fully appreciate or know the addictive properties of prescription opioids.

Opioid medications are frequently prescribed for severe pain. Opioids includes the pain medications like oxycodone, hydrocodone, morphine, and fentanyl as well as the illegal drug heroin (American Society of Addiction Medication, 2016). Many people rely on these drugs to relieve their pain from surgery, active cancer, chronic pain and end of life care (WebMD, 2017). Studies from the 2012 National Health Interview show that over 11% of adults report having chronic pain (Dowell, Haegerich & Chou, 2016). The opioid epidemic is a significant issue for nursing on the main respect that there is currently a problem with over- prescribing of narcotics and the millions of people addicted to opioid medications