A Response to Opioid Addiction

Transcription

1 A Response to Opioid Addiction Nancy Bradley, BSN, RN-BC The more I learn, the more I find I do not know I have over 20 years experience in Oncology, hospital based I have worked the last 14 years in out patient Pain Management Clinic Objectives Define why there is a need for Opioid Prescriptions Define why the current increase in Opioid misuse Discuss how to manage Non Terminal Pain without abusing or misusing 1

2 Pain is treated differently in the hospital versus as out patient Nociceptive Pain-Caused by injury to body tissue Somatic-Skin or musculoskeletal pain (surface) Visceral-Internal organ and smooth muscle pain (internal) Surgical/Severe Injury causing pain is initially treated with IV narcotics It s the right thing to do Prescribe oral narcotic-transition to home rehabilitation Why Narcotics Because they work! Opium poppy is first referenced in 3400BC as a Joy Plant and then around 350BC it was documented as being helpful in treating internal diseases 1800 widely used in America-commonly used as pain killer during the civil war 1853 hyper dermic needle was invented 1898 German chemical company, Bayer offered Heroin as a non addictive cough suppressant alternative to morphine synthesized from morphine stopped production in the early 1900 s 1970 Controlled Substance Act-Narcotics are ranked into five schedules based on their medical value, harmfulness and potential for abuse or addiction 1990 s Under treatment of pain-growing recognition of the need to manage pain 2000 Pain was introduced at the Fifth Vital Sign 2

3 We have gone from one extreme to the other Treat Pain Regulate Medication Government is controlling both ends and physicians are trying to balance in the middle Patients do NOT anticipate injury or deterioration of health with age When physical ability does not return to normal a psychological component is added to pain issue Many quality of life factors are affected Job Requirements Personal Role in Family Life Ability to Care for Ones Own Self Decreased muscle strength-lack of activity Stress 3

4 Patient falls into downward spiral Pain Depression Reluctance to Move Reluctance to Move Increased Pain Depression Increased Pain Physical Therapy is often key to improvement but unsuccessful due to downward spiral and hyper stimulated nervous system Patient is not motivated to be involved in own care, just expect to be fixed-now Have unrealistic expectations-0 pain Insurance Rehabilitation Coverage is limited Counseling may not be covered at all 4

5 The more I learn, the more I find I do not know Healthcare workers must be Vigilant in reviewing and practicing current patient based research It s not enough to read an article here and there Practice methods have to change when the evidence proves a better way Communicating practice changes and standing by them can be difficult! 5

6 First Do No Harm Conservative therapy-is best Realize no one is immune to marketing strategies-keep patients well being first Start low and go slow Educate patient-talk together to establish realistic expectations Make Referrals-counseling, dietary, surgical Document activity-patient involvement with realistic goals for muscle strengthening Get them off the couch! Patient Ownership Take ownership of your care Be involved Ask questions Ask questions again, until feel comfortable with plan of care Increase Activity-slowly You did not get this way over night, it doesn t go away overnight Biofeedback, Relaxation Search Internet, download app Patient Ownership Realize Miracles do NOT come in pill form Get educated about the laws and restrictions Listen, be open to changes Be responsible-clean out your medicine cabinet Report unwanted affects from your medication 6

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