...90 Americans die each day due to an overdose of opioid use. There has been an uptrend of misuse and addictions of opioids which includes prescription pain relievers, heroin, and synthetic opioids. This is considered a national crisis that is having a major impact on public health. The Centers for Disease Control and Preventions has estimated that the economic burden to the United States of opioid misuse is $78.5 billion a year. This estimation includes the cost of healthcare, treatments, and the criminal justice involvement (National Institutes of Health, 2018). This is one of the reasons why it is of great importance to get treatment...
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...Public health officials have linked the increase in heroin use to the increase in opioid pain prescriptions, along with heroin’s cheaper cost and increased availability (CDC, 2017). To prevent heroin addiction from forming, it has been instructed that health professionals revise when and how much opioid pain prescriptions are prescribed to patients (Substance Abuse and Mental Health Services Administration [SAMHSA], 2016). To prevent the scope of the heroin epidemic in the Northern Shenandoah Valley there are drug collection units throughout, including in Winchester and Berryville (NSVAC, 2016). The goal is to decrease the availability of unused prescription pain medication. This may prevent opioid abuse from beginning in teenagers and young...
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...III opioids for moderate to severe pain in cancer patients: Dose titration: A systematic review Palliative Medicine 25(5) 424–430 ! The Author(s) 2010 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0269216310386280 pmj.sagepub.com ˚ Pal Klepstad Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Intensive Care, St Olavs University Hospital, Trondheim, Norway Stein Kaasa Pain and Palliation Research Group, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Palliative Care, St Olavs University Hospital, Trondheim, Norway Petter C Borchgrevink Pain and Palliation Research Group, Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Center for Pain and Complex Disorders, St. Olav University Hospital, Trondheim, Norway Abstract The European Association for Palliative Care recommendation for starting morphine for cancer pain is dose titration with immediate release (IR) oral morphine given every 4 h with additionally doses for breakthrough pain. As part of a EU 6th framework programme to revise the guidelines we review the evidence regarding starting treatment and dose titration of opioids in...
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...cancer related pain continues to be a significant global health concern (Kaki, 2011). It is increasingly recognized within health care management that the more knowledge and skills a patient has about their condition, the greater their sense of control over their situation and pain relief interventions are likely to be more effective (Street & Haidet, 2011). So too, health professionals who are confident and competent assessing and managing pain are far more likely to consider themselves in control of their practice and feel able to deliver effective health care as they see the patient perspective view of levitating pain (Macintyre, Schug, Scott, Visser, & Walker, 2010)....
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...Management Focusing on Acute Pain: A Multidisciplinary Concept Analysis The concept of managing acute pain is extremely significant to nursing as pain is one of the most common problems for which patients seek out health care resources. Pain is a complex and abstract concept that encompasses sensory, emotional, psychological, social, and spiritual perceptions of pain that may occur in combination with physical pain. Pain is difficult to describe and often hard to measure; although, most healthcare providers agree that pain is subjective and is to be measured qualitatively and quantitatively as the patient perceives its intensity. Pain can affect the quality of life of the individual by impacting them physically, emotionally, and financially. Pain can also impact the family and support systems. The treatment of pain and the loss of income due to pain increases the costs for health care, the individual, and the population. Analyzing and clarifying the concept of managing acute pain can increase the healthcare provider’s knowledge of acute pain management, define the concept of managing acute pain, and expand the understanding of the concept of managing acute pain. The aim of this analysis is to clarify the defining attributes of managing acute pain, identify antecedents that influence the perception of pain and the possible consequences of acute pain. Review of Literature To increase the understanding of the concept of managing acute pain, it is important to explore the definitions...
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...illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically.1 The same survey found that over 70 percent of people who abused prescription pain relievers got them from friends or relatives, while approximately 5 percent got them from a drug dealer or from the Internet.2 Additionally, the latest Monitoring the Future study—the Nation’s largest survey of drug use among young people—showed that prescription drugs are the second most-abused category of drugs after marijuana.3 In our military, illicit drug use increased from 5 percent to 12 percent among active duty service members over a three-year period from 2005 to 2008, primarily attributed to prescription drug abuse.4 Although a number of classes of prescription drugs are currently being abused, this action plan primarily focuses on the growing and often deadly problem of prescription opioid abuse. The number of prescrip tions filled for opioid pain relievers—some of the most powerful medications available—has increased dramatically in recent years. From 1997 to 2007, the milligram per person use of prescription opioids in the U.S. increased from 74 milligrams to 369 milligrams, an increase of 402 percent.5 In addition, in 2000, retail pharmacies dispensed 174 million prescriptions for opioids; by 2009, 257 million prescrip tions were dispensed, an increase of...
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...Child and growth development theories influence the way we assess paediatric patients and helps to improve communication between practitioner and patient using age appropriate concepts. Understanding cognitive development theories will benefit nurses, providing competent paediatric care in all medical situations. A ten-year-old girl has presented to the emergency department with suspected ruptured appendix. Presentation of acute appendicitis is the most common cause of emergency abdominal surgery in children ages 4 to 15 years (Wall and Albanese, 2015). Appendicitis occurs as a result of an obstruction of the lumen of the appendix. This is most commonly due to a faecalith although other causes such as lymph tissue growth, foreign bodies and tumours of the caecum exist. The intraluminal impaction leads to increased local tissue pressure and recruitment of the...
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...can best facilitate this process by conducting a thorough assessment, implement timely interventions, provide non-pharmacological methods of pain relief alongside or separate from pharmacological methods, and provide comprehensive health teaching regarding post-partum pain. Pain assessment during labour and delivery focuses on the physiological factors. The nurse must assess for maternal vital signs, degree of pain, fetal heart rate and pattern, and uterine activity before and after administration of medication (Wong, Perry, Hockenberry, Lowdermilk, & Wilson, 2006). It is important to assess which stage of labour the mother is in before administering medication particularly morphine, because if birth occurs within one to four hours of dose, newborn may experience respiratory depression; however, if dose is administered too early on, labour can be prolonged and delayed (Wong et al., 2006). These assessments are made to ensure the health risks to the fetus and the labouring woman are eliminated. Another important aspect of assessment is cultural factors specific to each patient and the instruments used to analyze the pain intensity level. Labour and delivery is perceived differently by each culture. The cultural assessment should encompass unique care giving behaviours and practices, presence of birth companions and assessment of view of childbirth as a wellness or illness experience (Wong et al, 2006). The patient's culture will also dictate how to express pain and whether pharmacological...
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...1001/jamainternmed.2014.4005. Medical Cannabis Laws and Opioid Analgesic Overdose Mortality in the United States, 1999–2010 Author Manuscript Marcus A. Bachhuber, MD, Brendan Saloner, PhD, Chinazo O. Cunningham, MD, MS, and Colleen L. Barry, PhD, MPP Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania (Bachhuber); Robert Wood Johnson Foundation Clinical Scholars Program, University of Pennsylvania, Philadelphia (Bachhuber); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Bachhuber, Saloner, Barry); Robert Wood Johnson Health and Society Scholars Program, University of Pennsylvania, Philadelphia (Saloner); Division of General Internal Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York (Cunningham); Department of Health Policy and Management, the Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Barry) Abstract Author Manuscript IMPORTANCE—Opioid analgesic overdose mortality continues to rise in the United States, driven by increases in prescribing for chronic pain. Because chronic pain is a major indication for medical cannabis, laws that establish access to medical cannabis may change overdose mortality related to opioid analgesics in states that have enacted them. OBJECTIVE—To determine the association between the presence of state medical cannabis laws and opioid analgesic overdose mortality. DESIGN, SETTING, AND...
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...Treatment Types for Oncologic Pain James Skelton Mercy College of Health Sciences Treatment Types for Oncologic Pain Nearly all those who are diagnosed with cancer will have some kind of pain associated with the disease process. This pain may be visceral, neuropathic, procedural, or psychological in nature. This paper is a discussion of the different procedural guidelines that are currently used by the World Health Organization in the treatment of oncologic pain. This is also a look at alternative therapies that may be used in conjunction with the previously accepted pharmacological treatment of Western medicine. Article Summary One The article written by Fielding, Sanford, and Davis (2013) is a review of the current step-by-step guidelines the WHO has had in place for some time along with a comprehensive assessment of pain, the use of opioids and their adverse affects, the role of adjuvants, and non-pharmacological means of cancer pain treatment. The WHO bases its algorhythm on simplistic, broad categories such as mild, moderate, and severe pain. The article itself is geared towards nurses because they have a unique role in advocating for the patient. The WHO has had a three step analgesic ladder that it has used as a basis for cancer pain treatment for nearly 30 years now. Fielding, et al. (2013), stated that health professionals need to go beyond this three step ladder that focuses primarily on physical pain. Cancer pain is not just a physical but a biopsychosocial...
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...Five factors of the patient’s history that demonstrate nursing needs 1) Client states continued post-operative pain. 2) Client has the inability to completely empty her bladder. 3) Client’s past health history shows infrequent physical examinations and had not performed breast self-examination. 4) Client currently weighs 89 lbs compared to her usual weight of 110 lbs. 5) Client expresses great concern over her future and the future of her two children. Nursing Diagnosis 1: Acute pain R/T post-op surgery M/B verbalization of continued postoperative pain. Desired Outcome 1: Patient will use self-report pain scale to identify current pain level and report comfort-function goal in the next 12 hours. Desired Outcome 2: Patient will perform ADLs and activities of recovery easily in the next 24 hours. Nursing Intervention 1 Check the patient’s vital signs and use a valid self-report pain tool to assess pain level intensity. Administer non-opioid analgesic for mild to moderate pain, and an opioid analgesic for moderate to severe pain before painful procedures or increasing physical activity (Ackley & Ladwig, 2011). Nursing Intervention 2 Assess the location of pain, intensity, characteristics, onset, duration, aggravating, and alleviating factors. Identify activities that cause or aggravate pain and offer pain medication prior to performing these activities. Evaluation method Patient understands how to use the pain tool to report pain level intensity...
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...pain, the importance of being pain free and what this would mean for Charles will be discussed through-out this case study. The World Health Organization (2008) say that freedom from cancer pain must be regarded as a human rights issue. Charles's pain was poorly controlled on admission so it took several hours for the nurse to assess and come to an agreement with Charles about how to manage his pain. The End of Life Care Strategy, written by the Department of Health have published the following guideline; " Ensure that pain amongst people approaching the end of life are kept to an absolute minimum with access to skilful symptom management for optimum quality of life." (Department of Health, 2008, p33). Historically, pain was seen as an emotion rather than a sensation that was experienced by the heart and not the brain (Meldrum, 2003). Pain in today’s society is seen as an unpleasant sensory and emotional experience associated with actual or potential tissue damage (International Association of the Study of Pain, 2011). Therefore, pain is not only experienced on a physical level such as intensity, location and quality but also with emotional feelings such as anxiety, frustration and depression. Pain is a multidimensional phenomenon and many health care professionals today adapt a more practical definition that states “pain is what the patient says it is and exists when the patient says it does” (Tollison, Satterthwaite & Tollison, 2002, p76). Since health care professionals...
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...CN301- Community Health Teaching Care Plan Guidline Student's Name: Nicole Carter Placement Agency: Methadone Clinic Assessment(identify a need for the client(s) or population you are working with, growth and development, characteristics, etc.). The individuals at the Methadone clinic are between ages 18-60. This age group is considered to be young and middle adulthood. Kozier &Erb(2010). Through my clinical experience and observations I did identify that mothers of all ages did not have a good knowledge base of what methadone is and what it can do for themselves and their babies. | Briefly discuss the importance of the chosen topic/issue. (Why is the topic important for your client(s)/population?) According to the Centre for Addiction &Mental Health, pregnant women who are still using opioids must contact their doctor right away as it is very important that they be assessed. Throught my clinical rotation, the staff and myself identifed that there was a need for teaching about the importance of Methadone for both mom and baby. They indicated that a lot of these mothers came into the clinic not knowing what methadone does to them or there unborn child. It is very important that these mothers of ALL ages to have a good knowledge of the effects of methadone and what it can do for both mom and baby. | Objectives for the session/activity. (Between 3 and 5 objectives). By the end of my presentation the clients of the methadone clinic will have: 1...
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... The opposition side says that substance abuse and addiction is a choice of behavior. In an article published by Psychiatric Times, Jeffrey A. Schaler, author of Addiction Is a Choice, stated “Addiction is a behavior and thus clearly intended by the individual person.” He goes on in this article talking about how the addict monitors their use and the amount they use, so they are aware of what they are doing which makes it a choice to use. However scientific research proves that the use of drugs and alcohol changes brain patterns and the release of hormones in the brain which actually causes addiction, a disease after the choice to use is in the past. If addiction is a choice then so would be choosing to live an empty life full of pain, health issues, loss, and jail time. Who in their right mind would choose to lead a life like that? Drug and alcohol addiction only begins as a choice which creates a disease developed when the brain is subjected to substance abuse over a period of time, once the brain patterns change, it’s not about choice anymore. The disease of addiction should not be judged by people who have no personal experience and are not willing to face scientific facts. Studies have proven how the brain goes through changes with the use of drugs and alcohol, yet for some reason scientific proof isn’t enough for some individuals. The choice to use drugs or alcohol arises in everyone’s life, and that is agreeable, but the changes that occur in the brain after even...
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...career. It safely and effectively meets the patient’s health care needs. We are given an insight into Josie Elliot’s pain management in postoperative care in which, Tanner’s model of clinical judgment is used holistically provide Josie’s optimum patient care. This provides a framework to enhance the process of making a clinical judgment in several situations. The importance of Josie Elliot’s pain management and potential effects of uncontrolled pain in postoperative care are discussed to provide full recovery for the patient’s needs. The importance of pain control is to provide patient comfort during the healing process in postoperative care. (Douglas & Schoenwald, 2013) Pain is considered the 5th vital sign during observations therefore the pain scale should be recorded during observations after surgery. Pain intensity is also assessed, as it is a quantitative estimate of the severity of the patient’s perceived pain. (Douglas & Schoenwald, 2013) Nurses also use pain scales to determine the pain intensity. (Ersek & Irving, 2012) For example, the numerical rating scale allows the patient to rate the level of pain from 0 -10. Nurses use a holistic approach to help the patient on how to deal with pain, helping them regain their physical, mental and spiritual health. (Seliman & Andosy, 2011) Family & patient education is also important as Lorig (2001) views it as a schema designed to improve patients’ health behaviours. (Oshodi, 2007) For example, deep breathing...
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