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NR 661 Week 6 Opioid Discussion: Indications & Standards for (COT), Risk of Opioid Addiction | Download To Score An A $10.99   Add to cart

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NR 661 Week 6 Opioid Discussion: Indications & Standards for (COT), Risk of Opioid Addiction | Download To Score An A

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Describe the indications of chronic opioid therapy (COT) and standards for initiating as well as maintaining COT? What are ways to stratify or even minimize patient risk of opioid addiction? Show Less

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  • April 22, 2022
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NR 661 Week 6 Opioid Discussion


Student: Rachel Brock-Childress

Pain is a common complaint that is encountered in healthcare. The feeling of pain is subjective
and unique to each individual, making it challenging for the healthcare provider to assess. With
chronic pain being one of the most common healthcare complaints, recent years have found a
rise in the number of opioid prescriptions that are written for patients, and in turn, an increase in
the rate of opioid misuse and abuse. According to Blendon and Benson (2018), the rate of
prescription opioid abuse has increased dramatically over the last 20 years. Cicero and Ellis
(2017) state that the United States is the largest consumer of opioids and has seen a significant
rise in the number of prescriptions for opioids from around 76 million in 1991 to an estimated
219 million in 2011. Blendon and Benson (2018) report that approximately 11 million Americans
misuse their prescription for opioids. Recent years have also brought about a surge in opioid-
related emergency room visits, hospital admissions, and deaths (Cicero & Ellis, 2017). These
alarming statistics have drawn national attention and created a need for change.

Describe the indications of chronic opioid therapy (COT) and standards for initiating as
well as maintaining COT?

Chronic pain can have devastating physical, psychological, and social effects on the patient
(Huber, Robinson, Noe, & Ness, 2016). It often leads to loss of productivity, depression, physical
limitations, and diminished overall quality of life; therefore, proper and appropriate treatment of
pain is essential to health and wellbeing (Huber et al., 2016; Lembke, Humphreys, & Newmark,
2016).

With the stigma and alarming statistics related to the overuse of opioid medications and opioid
abuse, healthcare providers must understand the vital role that they play in reducing the rates of
opioid-related morbidity and mortality. Part of the responsibility of healthcare providers in
addressing the opioid crisis is being prudent prescribers.

Prior to initiating chronic opioid therapy, providers must carefully assess all aspects of the
situation and conduct an in-depth discussion with the patient (Manchikanti et al., 2017). For pain
to be considered chronic, the International Association for the Study of Pain states that the pain
must persist beyond the typical length of time that it takes tissue to heal, which is approximately
three months (Dowell, Haegerich, & Chou, 2016). The benefits of using opioids to treat pain
must also outweigh the potential risk of harm, including serious side effects and high prevalence
of abuse (Lembke et al., 2016). In addition, providers must complete all the necessary and
appropriate diagnostic tests that are needed to thoroughly evaluate the cause of the pain, and
must also consider other, non-opioid treatment options (Argoff & Viscusi, 2014; Manchikanti et
al., 2017). Chronic opioid therapy should only be used when the potential benefits far outweigh
the potential risks and also when no other treatment options have been effective in alleviating the
pain.

Argoff and Viscusi (2014) states that once the decision has been made to prescribe opioids for
the long-term management of chronic pain, clinicians should conduct an in-depth discussion with
the patient regarding the potential for abuse and also establish treatment goals. Periodically
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