How nurses can help monitor potential opioid abuse in patients

Abstract

Opioid use raises genuine concern in the United States today; everyone has an opinion about opioids and their use. Recently hospitalized patients have refused to take opioids after surgery for fear they would become addicted. In addition, some physicians refuse to prescribe opioids in their practice, even if their patients has been compliant on 1–2 hydrocodone/acetaminophen (Norco) a day for many years. The current political climate and the “war on opioids,” has caused the unintended result of tightening access for the legitimate patient rather than limiting illegal access according to interviews with patients. An Emergency Room (ER) nurse or physician cannot adequately assess the motivation of a patient who comes to the ER for the third or tenth or thirtieth time for the same problem asking for an opioid for their pain, while they are also caring for trauma patients. It is difficult to know if this is drug-seeking behavior or a true pain exacerbation. Nurses can be at the forefront of policy design and protocol implementation throughout the various entry points of the health care system; this will enhance patient safety surrounding opioid use. National organizations have published guidelines and position papers to guide practice for primary care physicians, outpatient clinics, and hospitals to safeguard care. Opioid-sparing efforts are the future of health care.