Page 18 - University of Martland Nursing Forum - Winter 2017

INNOVATION
Mathias cares for a neonatal abstinence syndrome patient at Mount Washington Pediatric Hospital in Baltimore, where she’s worked for 25 years.
Tackling the Opioid Epidemic
TBy Gregory J. Alexander
he statistics are staggering: From 1999-2014, more than 165,000 people died from overdoses related to opioid
pain medication in the United States, with nearly 19,000 deaths in 2014 alone—a 369 percent increase over the number of opioid-related overdose deaths in 1999, according to the Centers for Disease Control and Prevention (CDC).
The frequency that health care providers have prescribed opioids for chronic pain relief has increased at an equally rapid rate. Since 1999, sales of prescription opioids nationwide have quadrupled, and in 2012, providers wrote 259 million prescriptions for opioid
pain medication, enough for every adult
16 WINTER 2017
attention to the problem of opioid misuse and overdose deaths,” she says.
Unlike cocaine or other drugs that
must be purchased from a drug dealer, “individuals can access prescription drugs, particularly opioids, from a primary
care physician, a dentist, or even their grandmother’s medicine cabinet,” Fornili says. In an effort to combat prescription drug and opioid abuse, in April UMSON became one of the first nursing schools in the nation to commit to educating
its advanced practice registered nursing students on the CDC Guideline for Prescribing Opioids for Chronic Pain, released in March. Also in April, Fornili represented the School of Nursing at the White House Champions of Change event on Advancing Prevention, Treatment, and Recovery, honoring community members working to prevent substance abuse, improve access to treatment, and support recovery.
The new CDC guideline is mainly
for primary care providers, who write nearly half of all opioid prescriptions; however, care of patients with chronic pain occurs in multiple settings, and efforts to improve prescribing safety
and curtail harms associated with opioid use must occur at all levels of practice. Therefore, Fornili recommends including the guideline in curricula for graduate and pre-professional programs, including undergraduate courses.
The guideline will help practitioners determine if and when to start prescribing opioids to treat chronic pain and offers information on opioid dosage and duration and how to reassess patient progress.
It also promotes the use of non-opioid therapy for chronic pain outside of active cancer, palliative, and end-of-life care.
“These guidelines provide dosage recommendations, which is critical,” Fornili says. “A patient who has undergone a root canal or other minor procedure should not be given a 30-day supply of OxyContin or Vicodin.” According to the guideline, a three-day supply is often sufficient for most acute pain, and more than seven days is rarely needed.
in the country to have a bottle of pills, according to the National Institute on Drug Abuse (NIDA).
“As a certified addictions registered nurse who has been involved in the
field since 1997, I have never seen anything of this magnitude before,” says Katherine Fornili, DNP ’16, MPH, RN, CARN, FIAAN, assistant professor at the University of Maryland School of Nursing.
Fornili says she believes the United States hasn’t dedicated adequate attention or sufficient resources to this growing epidemic, although she has
seen an uptick in efforts to combat the problem lately. “Once suburban, middle- class children began dying, individuals in power and politics started paying more
MIKE CIESIELSKI