Introduction
The opioid crisis is one of the most significant public health hazards in the United States and worldwide. In 2015 alone, out of 52,404 reported drug overdose deaths, 63,1% were from opioids (Vadivelu, 2018). The wide use of non-prescription medications for chronic pain facilitates the opioid addiction rate, which challenges the governmental enforcement of complete abstinence from non-prescribed drugs. While the opioid crisis is far from going away, new strategies focus on harm reduction rather than consumption prevention. Healthcare institutions and professional nurses can adopt harm reduction and prevention strategies to reduce the risk of complications in patients with opioid use disorder and potentially reduce the consumption rate. Different strategies were applied worldwide with varying results. While some of them require further studies and experiments, others can be incorporated into existing healthcare practices to help with opioid use harm reduction.
Discussion
One of the promising directions for reducing the opioid-related death rate is introducing less dangerous alternatives like medical cannabis. Medical cannabis has been proposed and used in some states as a replacement for opioid painkillers with positive results that include reduced mortality, better pain management, and significant reduction of healthcare costs for the states and the citizens (Vyas et al., 2018). The literature review by Vyas et al. (2018) has indicated a significant substitution of medical cannabis for opioid prescriptions and, in some cases, an overall decrease in opioid use. While further research on medical cannabis is restricted mainly by federal regulations, the existing results show significant potential for reducing the opioid use rate and the degree of related harm.
Another possible way of harm reduction is drug checking which includes chemical analysis and health consultations. Measham and Turnbull (2021) point out that drug-specific and drug-related harms outside of direct drug use are major public health hazards that can be effectively addressed and mitigated by drug checking. Risk communications and subsequent improvement in risk management can lead to more efficient harm reduction practices, particularly among opioid drug users. The study by Measham and Turnbull (2021) demonstrates that brief interventions, including health consultations, facilitate a more conscious and careful approach to drug use and, in some cases, lead to a reduction in drug use. The results of this study demonstrate an approach that professional nurses can use toward patients with opioid use disorder in their practice to potentially reduce the related harm. However, the idea of reducing harm without necessarily decreasing drug consumption remains controversial among healthcare professionals (Vearrier, 2018). The question of the ethical implications of this approach requires serious consideration.
While drug use remains the primary reason for opioid-related deaths, associated risks can be addressed by healthcare facilities and nurses directly involved in working and communicating with opioid users. Opioid maintenance therapy, needle and syringe exchange programs, opioid overdose education, and naloxone distribution decrease the related harms while not necessarily reducing the consumption rate (Vearrier, 2018). Other harm reduction strategies include reforming prescribing practices and introducing alternatives to prescription opioid medicine. However, the ethical concerns of these approaches have continuously prevented the development of governmental strategies for harm reduction. Abstinence from all non-prescribed medicines has been the federal government’s focus since the advent of the opioid crisis (Taylor et al., 2021). However, introducing harm reduction approaches into primary care and nursing care settings can engage patients with ongoing substance use and facilitate the development and accessibility of screening and prevention services.
Conclusion
Despite the governmental efforts to reduce nationwide opioid consumption, the related death rate has been steadily increasing. As a result, alternative approaches to the issue have been developed. Most of them focus on preventing and reducing consumption-related health and social harms and have shown positive results in reducing mortality and use rate. However, the reluctance of the federal government to recognize the efficiency and ethical nature of harm reduction practices remains a preventing factor for the broader implementation of these strategies.
References
Measham, F., & Turnbull, G. (2021). Intentions, actions and outcomes: A follow up survey on harm reduction practices after using an English festival drug checking service. International Journal of Drug Policy, 95, 1–10. Web.
Taylor, J. L., Johnson, S., Cruz, R., Gray, J. R., Schiff, D., & Bagley, S. M. (2021). Integrating harm reduction into outpatient opioid use disorder treatment settings. Journal of General Internal Medicine, 36, 3810–3819. Web.
Vadivelu, N., Kai, A. M., Kodumudi, V., Sramcik, J., & Kaye, A. D. (2018). The opioid crisis: A comprehensive overview. Current Pain and Headache Reports, 22(3), 1–6. Web.
Vearrier, L. (2018). The value of harm reduction for injection drug use: A clinical and public health ethics analysis. Disease-a-Month, 65, 119–141. Web.
Vyas, M. B., LeBaron, V. T., & Gilson, A. M. (2018). The use of cannabis in response to the opioid crisis: A review of the literature. Nursing Outlook, 66(1), 56–65. Web.