The opioid epidemic is a complex, multi-faceted crisis in America, requiring the attention and focused effort of all segments of the provider community — including nursing. Nursing’s role is a critical one, as recognized at the highest levels of nursing professional bodies.
Nurses at all levels see the potential and real impact of opioid abuse and addiction — even more so than other providers. Whether an entry-level nurse, or an advanced practice professional, we often are the initial and primary point of care for patients.
Understanding patients and their needs for pain relief is critical in detecting the potential for abuse, and as nurses, we know more about our patients than anyone. Nurses have the confidence of their patients, which allows us to help educate them about preventing addiction and seeking alternatives to relieve their pain, and we are in a position to recognize the signs and symptoms of potential opioid abuse and understand appropriate prescribing guidelines.
But are we trained enough to fulfill this critical role? The answer for many nurses is yes. At the university level, nursing education on opioids has become more consistent and robust over time, greatly adding to this necessary skill set for nurses. Additionally, the widespread focus on the opioid crisis has opened up many avenues for nurses and others in the provider community to build their knowledge base about opioid abuse and treatment.
Overall many nurses are well educated, but at different levels and in different ways. Gaps still exist in the knowledge base of many nurses to be able to contribute optimally to help address this crisis. Nurses at all levels should take advantage of education, training and resources offered by a growing number of organizations, including the Centers for Disease Control (CDC) and the American Nurses Association (ANA). And as best practices are continually developed to aid detection, nurses need to learn about them and apply as needed
Within our scope of practice, advancements in addressing opioid abuse and addiction are ongoing, and our education needs to be continuing as well for all levels of nursing. Changes in the Controlled Substances Act, for example, allow APRNs to prescribe buprenorphine to treat opioid addiction, acute pain, and chronic pain. APRNs need appropriate education, however, to provide this vital care to patients.
Nurses need to be proficient in employing the technology at our disposable to help prevent, detect and treat opioid abuse. With the prevalence of electronic medical records (EMRs), every opioid prescription should be logged into available prescription drug monitoring programs (PDMPs) created to curb abuse. PDMPs should be checked for prior prescriptions before new ones are prescribed. While these systems have been vital in helping to detect abuse and addiction and getting patients into treatment, they are only useful if accessed and used. Utilization of training and technical assistance solutions enhances the clinicians’ ability to access and benefit from these valuable databases.
Learning more about strategies for educating patients on how to avoid addiction and reduce the risk of drug diversion once home also is important. Patient education is a key component to prevention, and nurses are strategically positioned to provide important advice. Patients are more likely to consider information when it comes from a trusted source.
While much progress has been made to limit the damage of the current opioid crises, much more work needs to be done by all providers – and society overall – to turn the corner on this serious public health issue. By staying current in their education, nurses will continue to play a leading role in protecting our patients and working with our colleagues to stem the tide of opioid damage.