Risk And Risk Management Department : A Plan For Reducing The Frequency And Severity Of Accidents And Injuries

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).

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.

There is no question that the alarming rate of deaths related to opioid overdose needs to be addressed in this county, but the way to solve the problem seems to remain a trial and error approach at this point. A patient is injured, undergoes surgery, experiences normal wear and tear on a hip, knee or back and has to live with that pain for the rest of their life or take a narcotic pain medication in order to improve their quality of life and at least be able to move. The above patients are what narcotic pain medications were created for, a population of people that use narcotic pain medications for fun is what is creating a problem. Narcotics are addictive to both populations, however taking the narcotic for euphoric reasons is not the intention of the prescription that the physician is writing. The healthcare system needs to find a way to continue to provide patients that experience chronic pain with the narcotics that work for them while attempting to ensure the Drug Enforcement Agency (DEA) doesn’t have to worry about a flood of pain pills hitting the streets by granting access to the population with a substance abuse problem.

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.

America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted

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.

It is important for our culture in western society to educate doctors on how to modify and limit their prescribing behavior so that less people become dependent on opioid medication. Doctors must start limiting and monitoring the number of opioid prescriptions they administer to patients. Limiting the number of prescriptions will lower the chances for potential abuse within patients, as well as lower the ease of access and circulation of opioid medication on the streets.

Through my observations of the Narcotics Anonymous meeting I believe that my analysis could be beneficial to the realm of medicine. Centers for Disease Control and Prevention (2014) released a study that displayed, “health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.” Considering the mass amount of prescriptions being written nationwide, it is not surprising that one of the members in the NA meeting I attended was able to easily obtain painkillers from her doctor. The specific interaction I encountered during the Narcotics Anonymous meeting where the woman described that her addiction was being supported by the constant prescriptions written by her doctor

According to the Department of Health and Human services, over 650,000 opioid prescriptions are dispensed in one day. This translates to around 230 million prescriptions each year. This amount just barely falls short of being high enough to give every adult in the United States their own bottle of opioid pills. The loose prescribing habits of medical professionals are to blame for these absurdly high numbers. Current doctors will prescribe an opiate-based painkiller for anything from a backache, toothache, to even headaches. To give patients “highly addictive” drugs for low scale chronic pain over the three-days recommended max incurs high risk for tolerance, dependence, and potential addiction to opioids. Some would argue that doctors are simply doing their job by solving their patient’s pain problem and that people should not intrude upon a medical professional’s expertise. However, while doctors should be unbiased pillars of medical advice and treatment, they should also take into account the risks involved with their treatment for their patient’s sake. Particularly for opioid prescriptions, doctors should have to abide by dosing criteria, receive guidance on when to seek consultation, and know how to use their state’s prescription drug monitoring program (Alexander et al., 2015). According to Alexander et al., (2015) Prescription Drug Monitoring Programs (PDMPs) are underutilized by 81% of all prescribers.

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.

Prescribers play an important role in preventing the use and abuse of opioids. Physicians and regulators need more information about whether, and how, opioids should be used for treating chronic pain. Prescriber education about the best uses of opioids, including knowing when and for which patients they should be used is important in averting the drug abuse. FDA has recommended many educational training programs for clinician’s on the safest use of these

For my research, I would like to make an impact on the number of opioids prescribed at in the Emergency Department at Houston Medical Center. The United States has an opioid crisis and uses more opioids than all other countries in the world combined (Cassidy, Dasmahapatra, Black, Wieman, & Butler, 2014) . This usage of opioids leads to abuse, dependence and hyperanalgesia. The over prescribing of opioids became dramatically increased following pharmaceutical companies downplaying side effects related to their medications. With the addition of pain as a 5th vital signs and pain becoming a question on the HCAHPS, there has been a rapidly progressing sector of narcotic prescriptions.

To help combat the opioid crisis, there are some existing policies that have been set in place by the government and various agencies. For instance, the U.S. Centers for Disease Control and Prevention (CDC) have implemented the use of Prescription Drug Monitoring Programs (PDMPs). These state-run programs are electronic databases that track down the prescriptions of controlled substances, including opioids. Physicians and other medical personnel can utilize this database to look at specific information such as the type of drug prescribed, the quantity, and so on. In addition, they can look at a patient’s history with controlled substances, which in turn helps them to avoid the prescription of controlled substances to a person with possible

The reception of the campaign is well received. Majority of all doctors have implemented #1 recommendation of 3-day supply is sufficient for acute pain. Several physicians have downloaded the MME calculator and have used the clinical tool to demonstrate to their patients the importance’s of lowering dosages to prevent overdose risk. Several offices has implemented a protocol of not prescribing Benzos to patients with history of opioid