The purpose of this course to provide insight into the opioid crisis in the United States, and guidelines and strategies that are in place and currently being developed to determine the appropriate opioid use.
- To have an understanding of the current use of opioids in the United States
- To understand the short- term and long-term effects of opioid medications
- To have knowledge of the guidelines and strategies that are in place or currently being developed to help providers determine when and what the appropriate interventions to treat chronic pain should be.
Is pain really the fifth vital sign? In 1990s and early 2000s national organizations and regulatory agencies, like the joint commission set the expectation to “getting pain to zero” (Munzing, 2017). During this period of time is when the initiation of the term, pain is the “fifth vital sign” came about. Pain was called out to the nation, through the work of the regulatory agencies and the help of pharmaceutical companies (Munzing, 2017). Pharmaceutical companies developed stronger and long-acting opioids, not to mention upping their aggressive marketing game to physicians.Their marking pushminimized the potential risks make it easier for physicians to prescribe the medications with less conscious (Munzing, 2017). With easier access to opioid medications, it was discovered that short-acting opioids such as hydromorphone or oxycodone and long-acting opioids, when “broken” of their time-release coatings,resulted in enhanced euphoria and potentiation of their addictive nature(Munzing, 2017). The beginning of “pill mill” erupted in the US (Munzing, 2017). Physicians with good intentions, prescribed high-dose opioids due to lack of, or false education and limited experience and many other factors lead to patients who were started on opioid therapy for pain developed substance use disorders (Munzing, 2017). This resulted for some patient’s addictions, over doses and deaths.
Even with the increase rise in opioid use rates for pain, from 2000-2014 the rates of opioid sales continued to increaseand the number of opioid over doses quadrupled with a correlating increase of opioid related deaths (Munzing, 2017).
According to the Center of Disease Control and Prevention (CDC)(2017) more than 47,000 people in the US died of drug overdosesand 60.9% of which involved an opioid. The CDC (2017) also reported that approximately 44 people per day die in the US of opioid prescription overdoses, totaling to be more than 16,000 deaths annually, with the addition of benzodiazepine overdoses contributing another 8000 deaths. (CDC, 2017). The average emergency department reports the number of patients that are seen in their department for drug use and misuse annually result in more than 2.5 million Emergency Department visits(Munzing, 2017).