Description of the Problem
Pain management is the most widespread reason people resort to emergency departments. Opioids are drugs used in medicine to relieve severe pain and relax the body; however, they are sometimes the cause of overdose because their primary function is not correlated with medical goals. Due to the fact that they are highly addictive, multiple patients encounter physical and mental issues, which can lead to death. Veterans and older adults are primarily subjected to misuse or abuse of opioids because they tend to have multiple chronic diseases and other medical prescriptions (Hudson et al., 2018). Opioid medications may be prescribed once a thorough analysis of veterans’ health characteristics is held; otherwise, such treatment results in overdose.
It is especially vital to comprehend that the majority of veterans suffer from mental disorders after their deployment and typically start to abuse alcohol or drugs. Deployment or combat exposure complicates regular life, causing much stress on veterans. It was discovered that an American veteran is twice exposed to dying from opioid use than a civilian American (Wilder et al., 2016). Veterans’ most common illness is post-traumatic stress disorder (PTSD), which affects approximately 20% of them (Hudson et al., 2018). PTSD signifies that a veteran becomes emotionally unstable, hyperaggressive, and tend to have flashbacks or nightmares. Moreover, some suffer from chronic pains due to battle injuries.
As a result, they are often prescribed high-addictive anxiety remedies for self-medicating, including painkillers such as Vicodin or sedatives such as Lunesta. Attempting to soothe the pain, they develop tolerance to their effects and cannot quit, cultivating drug-seeking conduct. Even though overdose (Hudson et al., 2018). Therefore, there is an urgent need to reduce opioid-related treatment for mentally ill veterans because it may prevent many of them from overdosing and subsequent death.
Opioids are increasingly addictive drugs which cause overdose and multiple deaths. According to Gratton (2017), “on an average day in the United States, 3,900 people initiate the nonmedical use of prescription opioids; 580 initiate heroin use; and 78 people die from an opioid-related overdose” (p. 138). Veterans suffering from opioid abuse are typically socioeconomically marginalized; they tend to resort to the emergency department for help. Therefore, emergency clinicians have to address the issue of opioid use disorder to prevent the overdose epidemic and develop harm reduction practices.
Harm reduction refers to the public-health direction aimed at diminishing the negative consequences associated with specific behavior. Harm reduction for the veterans suffering from opioid abuse or misuse promotes well-being for those in the recovery process and for those who are not by providing access to the knowledge about drug effects on health. The organizations dealing with health detriment decrease recognized the importance of treating high-risk patients in the late 1990s by distributing the ideas of overdose prevention and naloxone usage. It was established that naloxone distribution was less adverse than opioid-related treatment (Bennett, Elliott, & Golub, 2015). Subsequently, it was used as the alternative to multiple opioid medications.
Furthermore, emergency clinicians searched for medications that would substitute opioid painkillers or modify the existing prescriptions and implement a multi-model pain moderating strategy. This strategy implies a prescription which includes a reduced dose of opioids and other soothing medications. However, such medicines impact the long-term treatment disproportionally, and even short courses of such therapy develop dependence in every patient. Yet, the essential strategy is to prescribe a few tablets to mitigate the risks of misuse. Moreover, emergency clinicians can reduce veterans’ morbidity levels by abusing opioids by suggesting annual screenings for Hepatitis C, B, and HIV. Such checkups are typically propped by social work and other health services that may impact patients’ outcomes. In addition, psychological well-being must be controlled because the emotional addiction is far more dangerous than the physical one. These interventions may prevent overdose cases and reduce the level of illicit substance abuse.
Significance to Nursing
Overdose events may be prevented and reversed once the clinician and patient are ready to work together. Yet, the therapy’s success primarily depends on the medical worker because their level of knowledge regarding pain relief corresponds with a client’s outcome. To compare, deficiencies in nurses’ readiness in managing the pain results in adverse health outcomes. Therefore, an emergency medical worker must perceive how to soothe the pain and reduce the patient’s sufferings by applying proper knowledge and attitude (Rosenberg et al., 2018). However, the practice demonstrated that emergency rooms lack professional nurses due to the lack of education and training. Moreover, they may adequately treat patients with an opioid overdose but encounter barriers because of missing competence in this sphere. In the majority of the cases, they do not have access to the necessary tools and remedies; thus, they cannot manage pain effectively.
Consequently, nurses must take up courses and educational programs to treat veterans suffering from opioid addiction or overdose. Besides, as the amount of cases grows, the scope of nurses’ duties must be extended. Taking care of emergency patients is vital and requires urgent action, and nurses will be able to provide it as soon as they are eligible. Therefore, knowing how to treat veterans with mental disorders abusing opioids should be added to the nursing programs.
Bennett, A. S., Elliott, L., & Golub, A. (2015). Veterans’ health and opioid safety-contexts, risks, and outreach implications. Federal practitioner: For the health care professionals of the VA, DoD, and PHS, 32(6), 4-7.
Gratton M. (2017). The ER doctor’s role in combating the opioid epidemic. Missouri medicine, 114(3), 138-139.
Hudson, T. J., Painter, J. T., Gressler, L. E., Lu, L., Williams, J. S., Booth, B. M., Martin, B. C., Sullivan, M. D., & Edlund, M. J. (2018). Factors associated with opioid initiation in OEF/OIF/OND veterans with traumatic brain injury. Pain medicine (Malden, Mass.), 19(4), 774–787.
Rosenberg, J. M., Bilka, B. M., Wilson, S. M., & Spevak, C. (2018). Opioid therapy for chronic pain: overview of the 2017 US Department of Veterans Affairs and US Department of Defense clinical practice guideline. Pain Medicine, 19(5), 928-941.
Wilder, C. M., Miller, S. C., Tiffany, E., Winhusen, T., Winstanley, E. L., & Stein, M. D. (2016). Risk factors for opioid overdose and awareness of overdose risk among veterans prescribed chronic opioids for addiction or pain. Journal of addictive diseases, 35(1), 42-51.