The War on Opioid Drug Use

The War on Opioid Drug UseCharmae Wainwright

Cleveland State University

HSC 410 - Evidence Based Practice

Fall Semester, 2019

The War on Opioid Drug UseMillions of prescriptions are written for pain medications, many of them powerful opioids that can cause serious side effects and lead to addiction. Though opioids have been proven to be very successful in calming chronic pain conditions, opioids have also been the leading cause of addiction. This highly addictive drug has ignited a war on opioid drug use because of the alarming death rates due to medication overdoses.

People misuse prescription opioids by taking the medicine in a way other than prescribed, taking someone else's prescription, or taking the medicine to get high. When misusing a prescription opioid, a person may swallow, inject, or snort the drug, (NIDA, 2019). Patients are able to receive opioid medication by being prescribed by a physician who has found a medical diagnosis. This paper will discuss how limiting the ability to prescribe narcotic medication and utilizing alternatives for pain management such as physical therapy, over the counter medications, or medical marijuana and much more have been proven to be favorable over the traditional practices.

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These changes will result in a positive change to decrease opioid addiction. There are many solutions to fix this problem and the research will prove just that.

P (Patient Population): Patients who have been injured

I (Intervention): alternatives like Physical therapy, over the counter medications, medical marijuana, therapy after prescriptions.

C (Comparison): Patients who become addicted to opioids

O (Outcome): Decrease in opioid addiction

Question: Does using other alternatives for pain such as physical therapy, medical marijuana etc.

, decrease the crisis of opioid addiction compared to the traditional prescription of opioids?

Key Words: "Opioid addiction", "Physical therapy, Medical Marijuana, Over the counter medications", "Decrease in opioid addition"

ReferencesBrady, K. T., McCauley, J. L., & Back, S. E. (2015, September 4). Prescription opioid misuse, abuse, and treatment in the United States: An update. The American Journal of Psychiatry, 173(1), 18-26. Doi: HYPERLINK "

This journal article from, The American Journal of Psychiatry, focuses on if changes that can be made to traditional prescribing practices will assist in the battle against preventing opioid abuse. Scientist received their reports from populations who self-reported their abuse and also relied on information from medical facilities handling opioids drugs. The findings suggest that policy and educational tools being implemented by the government are promoting responsible use of opioid drugs and changes such as abuse deterrent drug formulations may assist in the battle. Recommendations include 1) educating patients and providers about the risks associated with misuse and abuse, 2) enhancing Prescription Drug Monitoring Program utility and use; 3) increasing proper disposal of prescription drugs to prevent diversion; and 4) addressing key sources of diversion through enforcement. Research suggests that opioid substitution with psychosocial interventions is the best treatment option for heroin dependence, though it is limited research on how to treat opioid dependence. This article will assist in answering my PICO question by providing support on why other factors such as consider more frequent monitoring, pill counts, checking the Prescription Drug Monitoring Program at each visit and with each refill, using a decreased amount and supply of medication, regular engagement of mental health professionals or social workers, and incorporation of family members.

Haller, I. V., Renier, C. M., Juusola, M., Hitz, P., Steffen, W., Asmus, M. J., & Craig, T. (2016, December 10). Enhancing risk assessment in patients receiving chronic opioid analgesic therapy using natural language processing. Pain Medicine, 18(10), 1952-1960

In this peer review article from the Pain Medicine Journal, the authors assess how Natural Language Processing can be utilized as a tool for determining whether a patient may abuse opioid medications. Researchers targeted chronic non-cancer patients that had one opioid agreement with a physician, and this was studied over a five-year span. Data was collected through the Natural Language Process (NLP) algorithm that was over 90% accurate in the case of sensitivity, specificity, and positive predictions in identifying violations of opioid contracts. It was found that clinicians underutilizing certain screening tools that are available to determine abuse habits. It was found by the NLP screening tool found that those classified as high risk were three times more than likely to violate contracts. This review is limiting in regard to specifies of the opioid contracts but accurately concluded that NLPs can support clinicians in screening for potential abuse in patients on longer term opioid therapy. This will support my PICO question by proving methods that can assist in preventing someone from becoming addicted to opioids. This research article in my opinion is high in quality due to the amount of statistics found within it.

Martin, C., & Cody, B. (2014, June 10). Improving opioid prescription practices and reducing patient risk in the primary care setting. Journal of Pain Research, 7, 301-311. Doi: Journal of Pain Research peer review article aims to focus on the downfalls of primary care physicians prescribing opioid medications. Primary care physicians are more likely to be overloaded with work and may have a hard time juggling patients and effectively monitoring their use of opioid medications. The populations focused on in this study were patients who are being treated for chronic pain not caused by cancer. The populations studied were those with complex life situations who may have also been suffering from mood, stress, and psychiatric disorders. Recent reviews of opioid addiction have prompted guidelines for prescribing opioid medication. There are now 13 protocols for clinical guidelines on treating non-cancerous pain. Chronic pain has been deemed as its own disease and therefor patients should be treated by those specializing in pain management care as opposed to being treated by a primary care physician. This article shows the different ways that professionals can identify and predict risks for future drug abuse related behaviors in patients.

Ferries, E. A., Gilson, A. M., Aparasu, R. R., Chen, H., Johnson, M. L., & Fleming, M. L. (2016, October 13). Prevalence and factors associated with multiple provider episodes in Texas: An epidemiological analysis of prescription drug monitoring data. Pain Medicine, 18(10),1941-1951. Doi: peer review article utilizes resources to determine the prevalence of multiple provider episodes (MPE's) and the factors that are associated with these practices in population in Texas. The primary population groups studied were those in various counties throughout the state of Texas. The data was collected using a retrospective cohort analysis along with county census data. Descriptive statistics were also used to estimate the possibility of abuse using data from prescription drug monitoring databases (PDMP's). The main arguments by the reviewers were that controlled substance prescriptions were more likely to be opioids and the average daily dose was well over 100mg. Such high doses along with other factors such as younger age and traveling longer distances for care are contributing to increased risk for chronic use of opioid medications. Overall, it was concluded that there is an underestimate of previous levels of abuse and the metro areas of Texas are experiencing higher rates of abuse. The issues of abuse need to be addressed on individual levels as well as through legislation changes.

Nguyen, A. (2019). The Alternative to Opioids: Marijuana's Ability to Manage Pain Caused by Injuries Sustained in the National Football League. Texas Review of Entertainment and Sports Law, 63-80. the journal, The NFL Should Stop Trying to Weed Out Marijuana: Why Medical Marijuana Remedies the League's Misuse of Pain Killers, believes that the National Football League should encourage medical marijuana use as an alternative for pain treatment for its players. Currently league players are tested for certain drugs and are prohibited from certain amounts of THC in their urine, positive drug test to this will be a large fine to multiple game suspensions. Studies have recently, and consistently, demonstrated the benefits of medical cannabis, not only for lower pain centralization, but also for reduction in opioid usage. University of Michigan conducted a study in June 2016 that suggests many chronic-pain patients, who were usually treated with opioids, experienced many benefits when medical cannabis was substituted in place of opioids. Further, in March 2017, a study showed that the rate of hospitalization due to painkiller and opioid abuse and dependence dropped an average of 23% in states where medical marijuana was legalized.12 Not only did opioid overdoses alone drop 13% overall for hospitalization, but fears that medical marijuana would lead to hospitalizations were proven to be unfounded. The NFL only proposes a less harsh penalty for recreational marijuana but must still come up to a solution that is in the best interest of their players health and safety. This