Introduction
Chronic pain is one of the most prevalent concerns in nursing practitioner work due to the omnipresence of this issue in patients with various diseases. Given the burden of the problem on patients’ daily existence, chronic pain management is essential to maintain patients’ quality of life and daily well-being. However, since pain management medications are predominantly based on opioids, their use is marked by a high likelihood of patients’ dependence, which causes an addiction problem. Given such devastating aftermath of opioid-based chronic pain management, it is essential to implement changes to this nursing practice issue to reduce the burden of opioid dependency pandemics in the chronically ill population.
Scope and Relevance of the Issue
Long-lasting pain associated with chronic health conditions is often impossible to eliminate, which necessitates its management in order to provide patients with proper social engagement, psychological stability, and overall well-being on a daily basis. The problem of opioid addiction has become a national crisis in the USA, suggesting the issue’s scope and high prevalence level. Indeed, according to Marshall et al. (2019), “the Centers for Disease Control and Prevention (CDC) reported approximately 89 deaths per day and a total of 32,445 deaths in 2016 due to prescription opioid overdoses” (p. 132). This number was approximately 10,000 deaths higher than the same indicators for the previous year, which implies an increase in the epidemiology of the issue (Marshal et al., 2019). Thus, dependence on opioids due to their extensive use in chronic pain management has significant mortality risks and must be addressed by nursing practitioners.
When reviewing current scholarly literature on opioid addiction in chronic pain management, one might detect that there are multiple studies devoted to analyzing the causes of the problem and the paths to solving it. Both generalist views and specific inquiries have been conducted to investigate opioid treatment in general and the use of particular medications. For example, Volkow et al. (2018) claim that “opioids have only limited effectiveness in the management of chronic noncancer pain, and the increased availability of prescribed opioids has contributed to upsurges in opioid-related addiction cases and overdose deaths” (p. 451). Similarly, Sandhu et al. (2018) argue that when used in patients who experience noncancer pain, the hazards caused by opioid medications for pain management outweigh the benefits due to the high risks of addiction. Focusing on tramadol as a specific pain management medication, Subedi et al. (2019) claim that due to this drug’s chemical characteristics, it has fewer dependency triggers than other pain management medications, which justifies the substitution of morphine for tramadol. These literature findings highlight the relevance and significance of the issue and provide the basis for change implementation.
Recommended Change in Nursing Practice
Given the ambiguity behind opioid pain management, it is challenging to ensure that patients obtain effective pain relief without being exposed to dependency risks. However, as implied in the scholarly literature, several recommendations for nursing practice change might be suggested. Firstly, the approach of opioid tampering might be introduced to the nursing practice, according to which the dosage of opioid medications is gradually reduced without harm to a patient (Sandhu et al., 2018). Secondly, the popularization of non-opioid analgesics among patients with chronic pain might prevent addiction and subsequent mortality in this population (Volkow et al., 2018). Thirdly, interdisciplinary pain management programs might be initiated to implement alternative pain relief strategies alongside medications (Sandhu et al., 2018). Such an approach will enable minimizing risks of dependence in patients while offering them choices for finding individual best practices for chronic pain management.
Finally, introducing psychological practices to nursing might be a favorable solution to the opioid dependence problem. Indeed, behavioral interventions that help reduce the burden of pain and strengthen patients’ coping skills with mindfulness, relaxation, and other techniques might be useful for individuals with non-severe pain symptoms (Sandhu et al., 2018). Overall, given the recommended solutions, it is suggested that nursing practitioners should tackle the problem of chronic pain management based on patient-centered, evidence-based care with the identification of the individual needs of the served population. In this regard, it is essential to determine the proneness of a patient to opioid addiction and implement either tapering, medication substitution, interdisciplinary programs, or behavioral intervention accordingly. Undoubtedly, the change will not occur rapidly and will require a significant level of resource contribution, including time, expertise, and research. For that matter, continuous investigation and improvement of effective strategies should be enforced in nursing organizations and healthcare facilities.
Conclusion
In summation, the identified issue in the nursing practice that requires rapid change is the use of chronic pain management that causes opioid addiction. The prevalence and high mortality rates due to this issue necessitate nurses’ practice change that would minimize the use of opioids to eliminate dependency risks. Given the literature findings, suggested recommendations include opioid medication tapering, medication substitution, interdisciplinary pain management programs, and behavioral interventions. The implementation of these recommendations is anticipated to avert the opioid crisis in the long-term perspective.
References
Marshall, B., Bland, M. K., Hulla, R., & Gatchel, R. J. (2019). Considerations in addressing the opioid epidemic and chronic pain within the USA. Pain Management, 9(2), 131-138.
Sandhu, H., Underwood, M., Furlan, A. D., Noyes, J., & Eldabe, S. (2018). What interventions are effective to taper opioids in patients with chronic pain?. British Medical Journal, 362. Web.
Subedi, M., Bajaj, S., Kumar, M. S., & Mayur, Y. C. (2019). An overview of tramadol and its usage in pain management and future perspective. Biomedicine & Pharmacotherapy, 111, 443-451.
Volkow, N., Benveniste, H., & McLellan, A. T. (2018). Use and misuse of opioids in chronic pain. Annual Review of Medicine, 69(1), 451-65.