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Prescription Opioids

Enrolled on:

CE1006 | Contact Hours: 2

COURSE OBJECTIVES

The purpose of this course is to provide health care professionals with knowledge on the prescription opioid crisis in America and the essential role they can play in combating it. Upon completion of this course, the health care professional will be able to:

1. Identify the types of prescription opioid drugs and understand common associated terms.
2. Understand the basic pathophysiology of pain.
3. Identify the risk factors, signs and symptoms for prescription opioid drug abuse, addiction and diversion.
4. Identify alternative therapies for managing and treating pain.

RELEASE DATE

05/19/2022

EXPIRATION DATE

05/19/2024

AUTHOR

Sara Hilgenberg, LPN

CRITERIA FOR SUCCESSFUL COMPLETION

All learners must complete the entire activity and complete the evaluation to receive contact hours.

APPROVAL STATEMENT (ACCREDITATION INFORMATION)

This nursing continuing professional development activity was approved by the Ohio Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. (OBN-001-91).

In addition to states that accept American Nurses Credentialing Center (ANCC) courses, CE Leaders is an approved provider by the Florida Board of Nursing, and a registered provider with the Arkansas State Board of Nursing, District of Columbia Board of Nursing, Georgia Board of Nursing, Kentucky Board of Nursing, New Mexico Board of Nursing, South Carolina Board of Nursing and West Virginia Board of Registered Nurses (Provider # 50-33450).

RELEVANT FINANCIAL RELATIONSHIP

No one with the ability to control content of this activity has a relevant financial relationship with an ineligible company.

INTRODUCTION

The year 2020 in the United States had an opioid prescription dispensing rate of 43.3 per 100 persons (1). Although this is a much needed downward trend, 142 million opioid prescriptions is still a staggeringly high dispensing rate. From collective data gathered in 2019, Hydrocodone ranked 15 on the highest prescribed medication list for the US (2). Five prescription opioids landed in the top 200. While the overall dispensing rate in 2020 was 43.3 per 100, some counties across the nation had rates that were nearly nine times higher. Some of these “hot spot” counties are located in Virginia, Kentucky, Pennsylvania, and South Dakota (3). Understanding the magnitude of the prescription opioid crisis is crucial to today’s public health. Although adding pain as the fifth vital sign may have had good intentions, it is directly correlated to the rising number of prescription opioid abusers over the past two decades and into today. The shift has now changed to assist these patients by gaining knowledge in more effective and safer alternative therapies for pain.

RESOURCES

1. Substance Abuse and Mental Health Services Administration: https://www.samhsa.gov/ 1-800-662-HELP (4357) SAMHSA’s National Helpline is a free, confidential, 24/7, 365-day-a-year treatment referral and information service for individuals and families facing mental and/or substance use disorders.

2. Dual Recovery Anonymous: http://www.draonline.org/ or 1-913-991-2703

3. LifeRing Secular Recovery: https://lifering.org/ or 1-800-811-4142

4. Narcotics Anonymous: https://www.na.org/ or 1-818-773-9999

REFERENCES

1. U.S. Opioid Dispensing Rate Maps. Website. https://www.cdc.gov/drugoverdose/rxrate-maps/index.html. Updated November 10, 2021. Accessed February 9, 2022.

2. The Top 300 Drugs of 2019. Website. https://clincalc.com/DrugStats/Top300Drugs.aspx. Accessed February 9, 2022.

3. U.S. County Opioid Dispensing Rates, 2020. Website. https://www.cdc.gov/drugoverdose/rxrate-maps/county2020.html. Updated January 21, 2022. Accessed February 9, 2022.

4. Opioid Data Analysis and Resources. Website. https://www.cdc.gov/opioids/data/analysis-resources.html#:~:text=This%20rise%20in%20opioid%20overdose,increasing%20since%20at%20least%201999. Updated March 10, 2021. Accessed February 9, 2022.

5. The Origin and Causes of the Opioid Epidemic. Website. https://www.georgetownbehavioral.com/blog/origin-and-causes-of-opioid-epidemic#:~:text=The%20use%20of%20opioids%20to,the%20years%20following%20the%20war. Published August 14, 2018. Accessed February 10, 2022.

6. Sarah Deweerdt. Tracing the US Opioid Crisis to its Roots. Nature 573, S10-S12. https://doi.org/10.1038/d41586-019-02686-2. Published September 11, 2019. Accessed February 10, 2022.

7. N. Levy, J. Sturgess, et al. “Pain as the Fifth Vital Sign” and Dependence on the “Numerical Pain Scale” is Being Abandoned in the US: Why? https://doi.org/10.1016/j.bja.2017.11.098. Published January 19, 2018. Accessed February 10, 2022.

8. Opioids: Commonly Used Terms. Website. https://www.cdc.gov/opioids/basics/terms.html. Updated January 26, 2021. Accessed February 11, 2022.

9. Opioid Addiction. Website. https://medlineplus.gov/genetics/condition/opioid-addiction/. Updated August 18, 2020. Accessed February 11, 2022.

10. How Opioid Addiction Occurs. Website. https://www.mayoclinic.org/diseases-conditions/prescription-drug-abuse/in-depth/how-opioid-addiction-occurs/art-20360372. Published Feb 16, 2018. Accessed February 11, 2022.

11. Risk Factors for Opioid Misuse, Addiction, and Overdose. Website. https://www.dol.gov/agencies/owcp/opioids/riskfactors. Accessed February 11, 2022.

12. Anatomy and Physiology of Pain. Website. https://www.nursingtimes.net/clinical-archive/pain-management/anatomy-and-physiology-of-pain-18-09-2008/. Published September 18, 2008. Accessed February 13, 2022.

13. Schug SA, Daly HCS, Stannard KJD. Pathophysiology of Pain. Website. https://www.ncbi.nlm.nih.gov/books/NBK534269/. Published 2011. Accessed February 12, 2022.

14. Eric Strain, MD, Andrew J Saxon, MD, et al. Opioid Use Disorder: Epidemiology, Pharmacology, Clinical Manifestations, Course, Screening, Assessment, and Diagnosis. https://www.uptodate.com/contents/opioid-use-disorder-epidemiology-pharmacology-clinical-manifestations-course-screening-assessment-and-diagnosis. Updated July 28, 2021. Accessed February 11, 2022.

15. Signs of Opioid Abuse. Website. https://www.hopkinsmedicine.org/opioids/signs-of-opioid-abuse.html. Accessed February 11, 2022.

16. Deepak S Patel, MD FAAFP, FACSM. Opioid Addiction. https://familydoctor.org/condition/opioid-addiction/. Updated April 30, 2021, Accessed February 11, 2022.

17. Recognizing and Preventing Medication Diversion. Website. https://www.aafp.org/fpm/2001/1000/p37.html. Accessed February 12, 2022.

18. Donald Teater, MD. Evidence for the Efficacy of Pain Medications. https://www.nsc.org/getmedia/8ecdc0e5-ae58-43e8-b98b-46c205e1c2b2/evidence-efficacy-pain-medications.pdf. Accessed February 13, 2022.

19. Non-Opioid Treatment. Website. https://www.asahq.org/madeforthismoment/pain-management/non-opioid-treatment/#:~:text=pain%20management%20plan.-,What%20are%20some%20alternatives%20to%20opioids%3F,these%20are%20all%20they%20need. Accessed February 12, 2022.

20. Chronic Pain: Medication Decisions. Website. https://www.mayoclinic.org/chronic-pain-medication-decisions/art-20360371. Published January 9, 2021. Accessed February 22, 2022.

21. Adams R, White B, Beckett C. The Effects of Massage Therapy on Pain Management in the Acute Care Setting. Int J Ther Massage Bodywork. 2010;3(1):4-11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3091428/. Published March 17, 2010. Accessed February 13, 2022.

22. Treating Chronic Pain without Opioids. Website. https://www.cdc.gov/opioids/providers/training/non-opioid.html. Updated February 11, 2020. Accessed February 12, 2022.

23. Pain: You Can Get Help. Website. https://www.nia.nih.gov/health/pain-you-can-get-help#treating. Updated February 28, 2018. Accessed February 13, 2022.

24. Chiropractic Adjustment. Website. https://my.clevelandclinic.org/health/treatments/21033-chiropractic-adjustment. Updated December 4, 2018. Accessed February 13, 2022.

25. The Role of Acupuncture in Treating Chronic Pain. Website. https://www.practicalpainmanagement.com/patient/treatments/alternative/role-acupuncture-treating-chronic-pain. Updated April 3, 2019. Accessed February 13, 2022.

26. Neuromodulation, or Neuromodulatory Effect. Website. https://www.neuromodulation.com/neuromodulation-defined. Updated November 21, 2021. Accessed February 13, 2022.

27. Donald Teater, MD. Evidence for the Efficacy of Pain Medications. https://www.nsc.org/getmedia/8ecdc0e5-ae58-43e8-b98b-46c205e1c2b2/evidence-efficacy-pain-medications.pdf. Accessed February 13, 2022.

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