Opioid addiction, such as heroin and prescription pain medication, is a growing problem
in the United States and internationally. Knowledge and respect for the epidemiology
of opioid abuse and addiction, its consequences, and the role of the ED prescriber
and nurse in reducing the risk and sequelae of opioid abuse and addiction is critical
to reduce the incidence of adverse outcomes and deaths. This article will consider
briefly the historical perspectives, the epidemiology, and the causes and risk factors
of opioid abuse and review select evidence-based approaches that ED providers and
nurses may implement to minimize the risk of opioid abuse and addiction by reducing
inappropriate prescribing of opioids, implementing stronger prescription monitoring
programs, improving access to substance abuse programs, and expanding training in
the recognition of overdose and access to emergency overdose treatments.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency NursingAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- History of opium.Int Congr Ser. 2002; 1242: 19-21
- Heroin epidemics.JAMA. 1973; 223: 1155
- A contagious disease model for researching and intervening in heroin epidemics.Arch Gen Psychiatry. 1972; 27: 149-155
- White house summit tackles opioid abuse.Am J Health Syst Pharm. 2014; 71: 1242-1243
- Vital signs: demographic and substance use trends among heroin users—United States, 2002-2013.MMWR Morb Mortal Wkly Rep. 2015; 64 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6426a3.htm. Accessed September 15, 2016): 719-725
- Data overview: injury prevention and control: prescription drug overdose.(Updated March 14, 2016. Accessed September 15, 2016)
- Relationship between nonmedical prescription-opioid use and heroin use.N Engl J Med. 2016; 374: 154-163
- 2014 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 32nd annual report.Clin Toxicol. 2015; 53: 962-1147
- CDC grand rounds: prescription drug overdoses–a U.S. epidemic.MMWR Morb Mortal Wkly Rep. 2010; 61 (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a3.htm. Accessed September 16, 2016): 10-13
- cost analysis of hospitalizations for infections related to injection drug use at a county safety-net hospital in Miami, Florida.PLoS One. 2015; 10: e0129360
- Hospitalizations related to opioid abuse/dependence and associated serious infections increased sharply, 2002-12.Health Aff. 2016; 35: 832-837
- The science of drug abuse & addiction: drugs of abuse—heroin.(http://www.drugabuse.gov/drugs-abuse/heroin. Updated May 2016. Accessed September 16, 2016)Date: 2015
- The National Survey on Drug Use and Health (NSDUH) Report.(Published September 4, 2014. Accessed September 15, 2016)
- Driven by prescription drug abuse, heroin use increases among suburban and rural whites.JAMA. 2014; 312: 118
- Addressing the opioid epidemic.JAMA. 2015; 314: 1453-1454
- The CDC guideline on opioid prescribing.JAMA. 2016; 315: 1577
- CDC guideline for prescribing opioids for chronic pain—United States, 2016.MMWR Recomm Rep. 2016; 65: 1-49
- The prescription opioid and heroin crisis: a public health approach to an epidemic of addiction.Annu Rev Public Health. 2015; 36: 559-574
- Medication-assisted therapies—tackling the opioid-overdose epidemic.N Engl J Med. 2014; 370: 2063-2066
- Letter from the surgeon general.(TurnTheTideRx website) (Accessed September 15, 2016)
- Prescribing opioids for chronic pain [pocket card].(TurnTheTideRx website) (Accessed September 15, 2016)
- Emergency department prescription opioids as an initial exposure preceding addiction.Ann Emerg Med. 2016; 68: 202-208
- Fascia iliaca block for pain relief from proximal femur fracture in the emergency department: a review of the literature.Emerg Med J. 2014; 31: e84-e87
Grissa MH, Baccouche H, Boubaker H, et al. Acupuncture vs intravenous morphine in the management of acute pain in the ED [published online ahead of print July 20, 2016]. Am J Emerg Med. doi:http://dx.doi.org/10.1016/j.ajem.2016.07.028.
- Clinical policy: critical issues in the prescribing of opioids for adult patients in the emergency department.Ann Emerg Med. 2012; 60: 499-525
- Impact of an opioid prescribing guideline in the acute care setting.J Emerg Med. 2016; 50: 21-27
- The development of the Washington State emergency department opioid prescribing guidelines.J Med Toxicol. 2012; 8: 353-359
- New York City emergency department discharge opioid prescribing guidelines.(Accessed September 15, 2016)
- Injury prevention and control: opioid overdose: state successes.(Updated March 23, 2016. Accessed September 15, 2016)
- Mandating PDMP participation by medical providers: current status and experience in selected states.(Accessed April 18, 2016)
- Authorized requestors of PDMP data.(Accessed September 15, 2016)
- A multicenter, primary-care based, open-label study to identify behaviors related to prescription opioid misuse, abuse, and diversion in opioid-experienced patients with chronic moderate-to-severe pain.J Pain Res. 2015; 8: 361-373
- An overdose antidote goes mainstream.Health Aff. 2015; 34: 1624-1627
SBIRT article.
- Beliefs and attitudes about opioid prescribing and chronic pain management: survey of primary care providers.J Opioid Manag. 2014; 10: 375-382
- Patients with pain need less stigma, not more.Pain Med. 2016; 17: 1391-1393
- Primary care experiences of people who live with chronic pain and receive opioids to manage pain: a qualitative methodology.J Am Nurse Pract. 2016; 28: 429-435
- Opioid education and nasal naloxone rescue kits in the emergency department.West J Emerg Med. 2015; 16: 381-384
- Nurses’ role in preventing prescription opioid diversion.Am J Nurs. 2015; 115: 34-40
Biography
Jonathan Green is Director of Critical Care, Good Samaritan Hospital, Suffern, NY.
Article info
Identification
Copyright
© 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.