The epidemic of deaths due to addiction has reached an all-time high. In spite of more education in schools and high-profile leaders and entertainers speaking out against drug and alcohol abuse, addiction rates are soaring. Pain management nurses are an important part of the healthcare team to aid in identifying and managing this growing threat.

According to the Department of Health and Human Services (DHS), the U.S. is in the midst of a prescription drug overdose epidemic. Overprescribing practices have stemmed from the push in the 1990s to treat a patient's perceived pain without clinically-backed objective data such as validated pain assessment tools. Overprescribing, coupled with the importance of patient-satisfaction scores available online, created a snowball effect of opioid use in patients who would otherwise have been tapered off or denied prescriptions in the past.

RELATED: Pharmacological Pain Management: NCLEX-RN

Nurses are at risk of missing patients who are addicted to prescription pain medications for a number of reasons. One major cause is a lack of knowledge as to the risk of physical dependence created by opioid use. Physical dependence is where the body relies on an external source of opioids to prevent withdrawal symptoms. Normally, the body produces endorphins to prevent withdrawal, but as tolerance increases, the external source is required. Addiction is a disease classification where the uncontrollable cravings for opioids overwhelms the body's ability to reason, even to point of harm and self-destruction.

The most important way nurses can help patients who suffer from addiction is to become educated on the disease process of addiction and the resources available to this fragile population. Education related to recognition and response to substance-misusing patients can greatly improve a nurse's confidence in care for addicted patients. Many states require nurses to have pain management continuing education units when renewing their nurse license. Organizations such as the American Psychiatric Nurses Association offer free courses for recognizing and caring for patients who have substance abuse challenges.

Many institutions have implemented the use of validated tools to aid in the identification of addictive behaviors for patients being prescribed opioids for pain management. These tools, such as the Alcohol and Drug Diagnostic Instrument or the Opioid Risk Tool can either be administered by the healthcare clinician or completed by the patient. Some tools assess the potential for addiction whereas others assess the presence of substance abuse. Nurses must be aware of any screening tools available in their healthcare institution and become educated on how to administer or interpret the results of the tool.

As an integral part of the care team, pain management nurses must be confident in addressing the epidemic of opioid and other drug addictions in the U.S. The National Council for State Boards of Nursing, in partnership with many respected organizations, has created an Opioid Toolkit to address this growing concern among the healthcare community. Education can also address the challenge of nursing attitudes towards patients with addiction. Knowledge of the disease process and resources for treatment are the best ways to overcome biased attitudes that may hinder the nurse from effectively caring for this alarming and at-risk population.

Amanda Bucceri Androus, RN, BSN
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