Opioids are effective pain relievers which, however, should be prescribed with utmost caution and taken with care. Opioids are extraordinarily addictive and capable of building tolerance which may lead to overdose and death. In Florida, during 2013, 2,363 individuals died with one or more prescription drugs detected in their system (The Miami Coalition, 2014). Deaths caused by opioid overdose amounted to 10% of all deaths, and Miami-Dade County ranked second by the number of fatal outcomes (The Miami Coalition, 2014). However, the statistics reveal reasonably positive trends: since 2009, opioid abuse has been steadily declining at a rate of 4-10% per year.
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What aggravates the situation in a variety of contributing factors which a patient who was prescribed opioids may dismiss when voluntarily increasing the dose. For instance, the likelihood of an overdose is associated with a history of overdose, a history of addiction to any other substance, and a renal or hepatic dysfunction (Volkow & McLellan, 2016). Another contributing factor is depression which might be the case for Florida. The national average share of adults with poor mental health is 11,9% whereas, for Florida, it is 13,9% (Holicky & Phillips-Bell, 2016). Individuals with depression may seek to experience the effect generated by an excessive dose of opioids for relief and distraction.
The process of SBIRT for patients with a history of opioid abuse (Screening, Brief Intervention, & Referral Treatment) does not differ significantly from that for patients with addictions to other substances. At the screening stage, it is crucial to ask a patient about the frequency of opioid intake. If the frequency raises concerns, a medical practitioner needs to assess the severity of the condition posing questions that could reveal how dependent the patient is.
A brief intervention includes feedback and information on adverse implications, after which an MP may ask a patient to evaluate their readiness to take action on the scale from 0 to 10 (Kentuckiana Health Collaborative, 2018). Lastly, if a patient displays the symptoms of opioid dependency, they may be referred to mental health, substance use, or pain management providers for further assessment and treatment.
A video by Ideas Exchange, University of Colorado, showcases a scenario in which a nurse interviews a patient, Raneisha who suffers from chronic pain after she fell from a ladder. Through the PDMP (Prescription Drugs Monitoring Program), the nurse discovered that Raneisha contacted another prescriber to receive more opioid-based medication (Ideas Exchange, 2017). Moreover, to deal with crippling anxiety, the woman started taking benzodiazepine which in combination with opioids may be lethal.
The nurse guides Raneisha through three main stages of SBIRT. One should note that the nurse summarizes what the patient says, gives non-judgmental feedback, and asks for permission to share more information. Ganesha is reluctant at first; however, the nurse convinces her to try to switch to suboxone and seek therapy for her anxiety and addiction.
It is possible to recover from opioid addiction which may be attained by joining a support group. For instance, Enhanced Healing Wellness Center in Miami, Florida holds online outpatient sessions for affordable prices. Online counseling sessions are entirely confidential and HIPPA compliant. As for Miami’s rehab centers, patients dependent on opioids may be referred to Harbor Village situated in a picturesque setting and offering yoga and spa alongside cognitive and relapse therapy sessions.
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Opioid addiction is a dangerous condition that requires timely intervention due to the likelihood of a lethal outcome. Even though Florida shows improving statistics regarding the issue, medical practitioners still need to remain vigilant and cautious.
The monitoring process for those dependent on opioid medication includes three necessary steps: screening, brief intervention, and referral to treatment. Nurses are likely to meet such patients in their practice, which is why they need to consider studying prescribed medication abuse as part of their lifelong learning agenda. Moreover, nurses need to foster such personal qualities as patience and compassion, for it is a sensitive issue, and when put under pressure or confronted with disdain, patients suffering from addiction may become reluctant and stop seeking help.
Holicky, A., & Phillips-Bell, G. (2016). Florida life course indicator report. Web.
Ideas Exchange. (2017). The SBIRT interview: Opioid screening [Video file]. Web.
Kentuckiana Health Collaborative. (2018). Screening, brief intervention, and referral to treatment (SBIRT). Addressing unhealthy substance use in primary care settings. Web.
The Miami Coalition. (2014). Drug abuse trends in Miami-Dade county Florida: June 2014. Web.
Volkow, N. D., & McLellan, T. (2016). Opioid abuse in chronic pain. Misconceptions and mitigation strategies. New England Journal of Medicine, 374(13), 1253-1263.