The following blog comes from Vicki Buchda, Director, Care Improvement. Here she shares her thoughts about opioids and the language used through a nurse’s lens.
Much has been published today about the opioid crisis. Our Arizona Department of Health website has up-to-date statistics such as lives lost, naloxone administered and infants with neonatal abstinence syndrome. As a nurse, I ask myself what I can do to make a difference. Sometimes it is in the seemingly small things.
I recently gave a presentation at the Arizona Nurse’s Association convention. Several nurses thanked me after the session for touching on the impact of the language we use. It may seem so simple, but how we approach our patients and how we talk about pain and pain management with patients and families can make a difference.
The first area to be cognizant of is how we show up with people with opioid use disorder (OUD). Often it is with judgement about them even though science tells us that this is a chronic disease and that people with OUD don’t choose to relapse. Notice in the first paragraph I mentioned statistics. While statistics are startling, this is a personal problem. PEOPLE are affected by this disorder—mothers, fathers, sons and daughters. The American Hospital Association’s opioid toolkit has resources for helping to reduce the stigma associated with OUD. That stigma influences access to treatment and outcomes.
Another place that language has a role is in prevention. The opioid crisis we are experiencing today is fueled by overprescribing. There is, and has been, a legitimate role for opioids in pain management. But now we know that the number of days that a person takes opioids and the amount of opioids each day contributes to dependence. According to the CDC, taking an opioid for more than 3 months increases the risk of addiction by 15 times, and taking a higher dose also increases risk of addiction (CDC Vital Signs, July,2017). The solution is fewer days and lower doses.
Not only do we need to change prescribing practices, but we can engage patients and families in shared decision-making about their care. Implicit in shared decision-making is education. Healthcare professionals can:
- Raise awareness about the risks of opioid misuse and abuse to empower people to make safer choices
- Talk with patients and families about assisting them in “controlling” pain (not eliminating pain)
- Help to make patients more “comfortable”, not pain free
- Educate people about treatments and how they work. For example: “this medication is called ketorolac. It will help to control your pain by reducing inflammation and swelling”.
- Offer alternatives to opioids, such as heat and cold therapy.
Below we ask that you share a comment on how as a provider you’ve changed your approach to treating patients with OUD as we learn more about what works and what doesn’t. If you are a patient or a family member, share what your experiences have been this year since the Arizona Opioid Epidemic Act. Have you seen a change in the healthcare system or providers? Creating an open dialog will help us work towards being the Healthiest State in the Nation.