Premium Essay

Methadone Therapy

In: Other Topics

Submitted By lailaloo
Words 1258
Pages 6
Running head: Knocking on Death’s Door

Knocking on Death’s Door: Methadone for Palliative Care
Wendy M. Walker
NURS 407
February 23, 2015

Abstract
“Terminally ill.” “Six months to live.” “Hospice and Palliative Care.” These are just a few of the phrases that will completely turn a person’s life upside down. Effective and appropriate symptom management at the end of a hospice patient’s journey is vital. Health care professionals have a duty to provide ethical and compassionate care to patients. Ensuring that they spend their last days on earth comfortable and free of symptoms is not only the decent thing to do, but it also is very rewarding to a health care professional. With the correct combination of appropriate medications, a hospice patient can pass away peacefully, in the privacy of their own home, surrounded by loved ones.

Knocking on Death’s Door: Methadone for Palliative Care Patients on hospice care often experience pain from their terminal diagnosis, as well as a plethora of other symptoms limiting the peace and comfort they deserve during their final months, weeks, days, or hours. Hospice diagnoses include but aren’t limited to; cancer, end stage cardiac disease, COPD, Alzheimer’s Disease, Parkinson’s Disease, ALS, end stage renal disease, and cirrhosis of the liver. Passing away at home can be a beautiful, peaceful, and spiritual experience for the patient and family as long as symptoms are under control and the patient is comfortable. Towards the end of life, the human body undergoes a series of natural events and there are many different symptoms a patient can encounter, including severe pain. Typically, the patient hasn’t had anything to eat or drink for several days, maybe even weeks. They can become very disoriented and agitated. Often times, terminal restlessness occurs. The patient may cry out, attempt to crawl out of

Similar Documents

Premium Essay

Effects of Methadone Treatment on Heroin Dependency

...Running head: METHADONE AND DEPENDENCY The Effects of Methadone Treatment on Opiate and Heroin Dependency Since the early times, opiates, heroin, and other drugs have been used in providing analgesia as well as substitutes to reach a place of euphoria. Originally, as Yurgelum-Todd et al (2009) has noted, derived from the opium poppy, heroin has been used as an alternative to morphine in dealing with addiction (Yurgelum-Todd, p. 175, 2009). Unfortunately, over the years it has consistently become prevalent that heroin has more negative aspects than anything; heroin is highly addictive, resulting in consequences such as overdoses, infections, violence and crime, deficits in memory, learning, and attention. The need to relieve pain by use of heroin and other drugs, though, results in opioid dependence, estimated to affect more than one million persons in North America alone (Oviedo-Joekes, p. 778, 2009). To relieve opiate dependence, researchers experimented with an opiate-agonist called methadone; the standard opioid-susbstitution treatment, to help reduce withdrawals and other negative consequences surrounding the use of drugs like heroin by producing a phenomenon called the “blocking-dose”, which blocks opiate receptors (Oviedo-Joekes, p. 778, 2009). Methadone was, in fact, the “first opiate agonist used in the pharmacotherapy of heroin addiction. Methadone is the best studied drug, but also the most controversial”(Maremmani, p. 7, 2008)....

Words: 2764 - Pages: 12

Free Essay

Bupe Equivalence Table

...Bup Equivalent Dose | Subutex | Suboxone Film | Buprenorphine/naloxone tabs | Zubsolv | Bunavail | 2 mg | 2 mg | 2 mg / 0.5 mg | 2 mg / 0.5 mg | 1.4 mg / 0.36 mg | ½ of 2.1 mg / 0.3 mg | 4 mg | ½ of 8 mg | 4 mg / 1 mg | ½ of 8 mg / 2 mg | ½ of 5.7 mg / 1.4 mg | 2.1 mg / 0.3 mg | 8 mg | 8 mg | 8 mg / 2 mg | 8 mg / 2 mg | 5.7 mg / 1.4 mg | 4.2 mg / 0.7 mg | 12 mg | 1 ½ of 8 mg | 12 mg / 3 mg | 1 ½ of 8 mg / 2 mg | 5.7 mg / 1.4 mg+2 of 1.4 mg / 0.36 mg | 6.3 mg / 1 mg | 16 mg | 8 mg BID | 8 mg / 2 mg BID | 8 mg / 2 mg BID | 5.7 mg / 1.4 mg BID | 4.2 mg / 0.7 mg BID | Available buprenorphine formulation strengths: * Subutex sublingual tablet – 2 mg; 8 mg * Suboxone Film – 2 mg / 0.5 mg; 4 mg / 1 mg; 8 mg / 2 mg; 12 mg / 3 mg * Buprenorphine / naloxone sublingual tablet – 2 mg / 0.5 mg; 8 mg / 2 mg * Zubsolv sublingual tablet– 1.4 mg / 0.36 mg; 5.7 mg / 1.4 mg * Bunavail buccal film– 2.1 mg / 0.3 mg; 4.2 mg / 0.7 mg; 6.3 mg / 1 mg * Available buprenorphine formulation strengths: * Subutex sublingual tablet – 2 mg; 8 mg * Suboxone Film – 2 mg / 0.5 mg; 4 mg / 1 mg; 8 mg / 2 mg; 12 mg / 3 mg * Buprenorphine / naloxone sublingual tablet – 2 mg / 0.5 mg; 8 mg / 2 mg * Zubsolv sublingual tablet– 1.4 mg / 0.36 mg; 5.7 mg / 1.4 mg * Bunavail buccal film– 2.1 mg / 0.3 mg; 4.2 mg / 0.7 mg; 6.3 mg / 1 mg * Buprenorphine Equivalency Table Buprenorphine Equivalency...

Words: 321 - Pages: 2

Premium Essay

2-Ethylhexyl Trans-4-Methoxycinnate

...2-Ethylhexyl Trans-4-Methoxycinnate Information Retrieval Matthew Pratley i) Molecular Structure Drawing: Image 1: A molecular structure drawing of 2-Ethylhexyl Trans-4-Methoxycinnate as drawn on structure search on the Sigma Aldrich website (1) ii) Search: Iupac Name: 2-Ethylhexyl Trans-4-methoxycinnate (2) Other Names: Octinoxate (3), 4-methoxycinnimanic acid -2- ethylhexyl ester (3) (4) (5), OMC (3) (4) (5), Octyl Methoxycinnamate (3) (4) (5), These other names are found throughout the five products that have the molecular structure as image 1 above. The five products are: Product 1: 2-Ethylhexyl Trans-4-methoxycinnamate 98%, Contains 500-1000ppm BHT as Stabiliser (2) Purity: 98% (2) Cost: £27 per 50ml (2) £106.50 per 250ml (2) Product 2: Octinoxate Pharmacy secondary standard traceable to USP (3) Purity: Certified reference material (3) Cost: £ 50.40 per 1g (3) £ 255.70 per 10g (3) Product 3: 2-Ethylhexyl-4-methoxycinnamate 98% (4) Purity: 98% (4) Cost: £48.90 per 50g (4) Product 4: 2-Ethylhexyl-4-Methoxycinnamate Analytical standard (5) Purity: >98% (5) Cost: £38.90 per 100mg(5) Product 5: Octinoxate United States Pharmacopeia Reference Standard (6) Purity: Unavailable on website (6) Cost: £212.50 per 50mg (6) iii) Technical Data: For the Technical Data we will focus on Product 1 from ii) Search due to it having the most information readily available from the source. CAS Number: 83834-59-7 (2) Molecular Formula/Molecular...

Words: 671 - Pages: 3

Premium Essay

The Therapeutic Relationship Between Client and Clinician

...Clients for Specific Clinicians The relationship between the clinician and the client is a crutial aspect for the therapeutic outcome. Having a connection between the client and therapist can have many determining factors that lead to a positive evaluation and outcome of the therapy. There are many components and attributes a therapist must be aware of and contain to have a good helping relationship with their client. A client wants to have a positive experience when receiving help and if there is no relationship or positive understanding between each the outcome could be negative or the client could stop therapy early. The concept that was thought of in the early 1900’s to profile clients and match them with a clinician that would possibly have a more successful outcome with therapy should be used in a lot of therapeutic helping relationships, and goes along with the importance of having a good clinician-client relationship. Being able to profile a client to find out which therapist would be a good fit for them, would help the initial alliance between the therapist and client. A client’s relationship with their therapist is very important in helping have a positive outcome at the end of therapy. According to the article “Relationships Among Client-Therapist Personality Congruence, Working Alliance, and Therapeutic Outcome” both client and therapist have their own ways of thinking, morals, behaving, and other characteristics that will influence how they relate to each...

Words: 1251 - Pages: 6

Premium Essay

Analysis of Rogers Interview with Gloria

...Section 11: Regulations of the Student Course Handbook, pp. 78-81). 1st Marker 2nd Marker Agreed Mark 1st Marker 2nd Marker Agreed Mark Student Declaration: "I declare that the work submitted is my own" Section C Tutor’s Comments A qualitative analysis of Carl Rogers famous interview with Gloria, encountering the basic principles of the client centered approach. Abstract This paper is a qualitative analysis of the famous Carl Rogers interview with Gloria filmed in 1964 in the United States of America. The basic concepts of the client centered theory and therapy will also be encountered in addition to an evaluation of the necessity and importance of the core conditions in the counseling process. Introduction Person centered theory is regarded as one of the most influential theories of counseling and therapy since its development in the 1940s. With the development of the person centered theory its originator Carl Rogers revolutionized the field of psychotherapy. He believed that people are capable of solving their own problems when the right conditions...

Words: 2695 - Pages: 11

Free Essay

Organized Behavior

...This demeaning and hostile environment was initially created by direct face to face interactions, personal written notes and the manager of the rehabilitation hospital. After nearly 4 years of abuse the co-worker resigned from the position and the abusive co-workers remained at the job despite various reports sent to the manager about the abuse. B. The assistant of the rehabilitation hospital was in charge of the day to day flow/duties of patient care within the hospital. The day to day flow/ duties consisted of tasks such as: preparing wheelchairs for patients (pts.), putting equipment away, organizing recreational activities for pts., filing various documents on pts. and assisting pts. with various dressing routines in preparation for therapy. Initially, during the first year of being on the job, the assistant was well received by the therapists and commended on several occasions for her willingness to help anyone with anything and for doing an exceptional job at completing her day to day duties. Then a big turnover happened within the hospital in which all the therapists from the assistant’s first year were replaced by all newly graduated therapists. This major turnover also brought about a change within the “thought process” of management. Several of the newly graduates never worked in a hospital setting and began to fall behind with scheduling and accurately treating patients. The manager called a meeting in which she directly informed...

Words: 978 - Pages: 4

Premium Essay

Smoking Cessation

...to quit smoking. It should explain how the methods work and what former smokers that have used those techniques experienced with them. The classical means of smoking cessation are medical treatments. They vary from laser therapy to drugs that substitute Nicotine and other ingredients of cigarettes. The psychological approaches to quit smoking have gained more popularity in the last few years. Especially hypnosis is often considered as a very effective method to overcome smoking. Also acupuncture can be seen as a psychological approach since it affects the mind and not the body. In comparison to medical approaches, hypnosis and acupuncture cannot impact the body. It can also be cheaper than a laser therapy for example. However, not every individual is receptive for hypnosis and acupuncture. This makes the medical methods more reliable. The central issue is, that every smoker who wants to overcome his addiction should try different methods, both psychological and medical. My thesis is, that the most effective way for smoking cessation is a combined therapy of psychological and medical treatment. Further Examination & Discussion The main issue about smoking cessation aided by hypnosis is the fact that not every patient is receptive for this therapy. As H. Sutcher (2008) states, there are several stages of...

Words: 1461 - Pages: 6

Premium Essay

Personal Theory of Counseling

...Counseling of Counseling or Psychotherapy Introduction This application paper will discuss my personal theory of counseling or psychotherapy in a number of different areas. Specifically, I will discuss the seven areas of interest. First, I will discuss and describe my basic view of human nature, Second, I will determine key factors that account for changes in behavior. Third, I will describe the nature of the therapist client relationship and its importance. Fourth, I will describe key functions and role of the therapist. Fifth, I will discuss the goals of therapy. Sixth, I will determine the techniques and theories of my approach. Seventh, I will discuss specific client issues best suited for my approach. (Walden University, 2012). In this paper I plan to describe and explain my own personal model for counseling. My personal model of counseling uses Gestalt Therapy, Person Centered Therapy, Existential Therapy and Adlerian Therapy which I think complement one another well My Basic View of Human Nature My basic view of human nature is a combination of Person -Centered, Gestalt and Existential theories of counseling (Corey, 2013a). I believe that we are all searching for what it means to be human. I also believe that people are both the product and the process of their choices that are influenced by thoughts and emotions. Self-awareness in the individual leads to greater freedom in the...

Words: 3616 - Pages: 15

Premium Essay

Depression

...and feeling worthless. Depression, among other psychological issues, can be treated with such orientations such as psychodynamic therapy, cognitive behavioral therapy, and biomedical therapies. Psychodynamic therapy suggests that one’s behavior and feelings are affected by their unconscious motives. It also suggests that one’s problems may be a result of unconscious conflicts leftover from childhood. The treatment corresponding with psychodynamic therapy includes the recovery of these unconscious conflicts through free association. This is where one will express thoughts exactly as they come without thinking. Another technique is dream analysis where a therapist can uncover the unconscious through interpreting the symbolic meaning of a client’s dreams. Transference is another technique used in which has proven to be successful because a client can reenact crucial relationships in a therapeutic environment which can bring out suppressed feelings of conflict so that they may be dealt with. Cognitive therapy’s suggests that a person can develop certain issues though how they perceive everything around them, especially if a person is habitually negative in their way of thinking. This form of treatment blends verbal and behavioral interventions. The main goal of cognitive therapy is to change negative thoughts and maladaptive beliefs. Biomedical therapy suggests that one’s behavior can be caused by biological factors such as genes and hormones. The two main forms of treatment...

Words: 357 - Pages: 2

Premium Essay

Carl Rogers

...Rogers emphasized the therapeutic relationship in positive terms. He was one of the first psychologists to talk about optimal mental health. He engaged clients with a sincere appreciation of their own expertise in themselves. Less of an "expert" he was more a co-facilitator in clients' own therapeutic journey. The fundamental belief with this therapy is that the client wil eventually reconnect with their inner potential and do what they feel is ultimately comfortable for themselves. Rogers here is allowing her to find her own answers as thats the whole point really, he has total faith in her that she is self empowered in this way and that she has the ability to find the answers that are already inside of her as a mother. Rogers is not the expert on this, she is , so he wont answer. Rogers believed that we all have the resources within ourselves to sort our own issues. Rogers develops this theory through open questions and summaries, whilst maintaining an empathetic understanding of any decision she could make. He does not advise, but works with her own desires, to counsel. The transition that Gloria takes from having concerns with `lying`to her daughter to realizing that her daughter is not an issue here, rather it is her own self-acceptance that is judgemental of what she does with her love life. Roger's theory goes to the core of who we are as human beings - afterall we are social animals. A therapist guides in a non-directive way: This means there's a...

Words: 344 - Pages: 2

Premium Essay

Adlerian Approach

...Adlerian Approach with Abby Sylvia Montalvo Walden University Adlerian Approach with Abby The therapeutic approach in the case profile of a client named Abby after an assessment is given, and a summary is developed based on the information collected is the Adlerian approach. According to the COUN 6722 study notes, Abby is a 57 year-old African American women who came into the office seeking counseling. Abby works part-time as a free-lance editor. Abby has a bachelor’s degree in literature. Abby is married to her husband Ron who was diagnosed two months ago. Abby has a difficult time accepting that her husband was diagnosed with cancer (Walden University, 2012). She cannot cope with the situation, therefore Ron’s brother is the one who takes him to have his treatments, and to his doctor’s appointments. Abby is depressed, and spends her time crying, sleeping, has lost her appetite, and feels fatigued. She feels guilty that she is not supportive toward her husband (Walden University, 2012). Abby has always believed to be hopeless throughout her life. She has low self-esteem, and believes that everyone around her has a better life than she does, though she has lived comfortably. Abby has expressed that she suffered from migraine headaches in her twenties, which has become worse over the years (Walden University, 2012). Doctors have prescribed medications for the migraines, which has not been effective. Abbey claims that she drinks alcohol two...

Words: 1243 - Pages: 5

Free Essay

Annottated Bibliography

...Student’s Name Professor’s Name Course Date Information technology in rehabilitative therapies Computerized medical devices, assistive technology and prosthetic: An Annotated bibliography. Vision-Realistic Rendering: Simulation of the Scanned Foveal Image with Elimination of Artifacts due to Occlusion and Discretization - Springer. (n.d.). Retrieved from http://link.springer.com/chapter/10.1007%2F978-3-642-25382-9_1#page-1 This book chapter introduces and explores the Concept of Vision realistic rendering. The chapter comes up with a technique for simulating an image of the foveal that is scanned from wave front data of human subjects, and it also demonstrates the techniques on sample images. The source is a chapter of a book found online. The author is an affiliate Professor of Optometry and also a Professor of Computer Science at the University of California. The objective of the source is to introduce a new concept to the reader. The resource is relevant to me sine it introduces new concepts in Ophthalmology; also, the source is relevant to my topic since it explores how patients with eye disease like Keratoconus see. Prentke Romich Company. (2015). What is Augmentative and Alternative Communication? - AAC and Speech Devices from PRC. Retrieved from https://www.prentrom.com/what-is-augmentative-and-alternative-communication The webpage describes Augmentative and Alternative Communication (AAC). The post further introduces the two systems of AAC. Lastly, the post exemplifies...

Words: 549 - Pages: 3

Premium Essay

Reducing Medication Errord

...Reducing Medication Errors Medication errors are a major problem in the healthcare community, and especially in pediatrics. “Up to 27% of all pediatric medication orders result in a medication error.” Keiffer, Marcum, Harrison, Teske, and Simsic (2014). There is far less room for error with drug administration when working with pediatrics. It should be a primary goal to significantly reduce the cases of medication error in ever facility. I will discuss the importance of reducing medical errors relating to a Pediatric Cardiothoracic Intensive Care Unit. The article titled Reduction of Medication Errors in a Pediatric Cardiothoracic Intensive Care Unit discusses the rate of medication errors in their unit, and the steps that were taken to try to eliminate or reduce the number of medication errors. “A medication error is defined as an error that occurs with the prescribing, dispensing, administering, adherence, or monitoring of a drug regardless of whether it results in patient harm or has the potential to result in patient harm.” Keiffer et al. (2014). The authors note that medication errors occur more often with administration issues as opposed to prescribing, ordering dispensing, or monitoring. The article discusses the health care professionals’ courses of action taken to reduce medication errors for their patients. The medical team implemented interventions and methods including: a double check system, hands free communication, a safety systems checklist, a distraction-free...

Words: 323 - Pages: 2

Premium Essay

Psychosocial

...observed life obstacles. Will Hunting is a 21-year-old Caucasian male, who has sought treatment for uncontrollable feelings of anger, anxiety, and emotional withdrawal. Will is of average height, casually dressed, and well groomed and has bright blue eyes and blonde hair. He sits with a slouched posture and talks with a thick Boston accent. Will is a self-taught, intelligent person, who solves difficult math theorems that have stumped others. Will reports being in good physical health including eating healthily and visiting the gym twice a week. He only goes to the doctor when he absolutely needs to, and he has never been on medication to manage his anxiety or anger. Will is willing to work with the therapist and the agency. Initial therapy sessions take place at the agency in San Francisco. Will expects to get a better understanding of his emotions so he can start a life with his girlfriend, Skylar. Will and Skylar live together in an apartment in a suburb of San Francisco. Will talks about dating Skylar while they were in Boston, when she confessed her love for him and asked him to move to California with her upon her starting at a new school. Will rejected the offer, citing his disbelief in her ability to accept his emotional baggage. His eventual decision to move to San Francisco was made to reconcile with her. Will discovered his tendency to push people away and deliberately...

Words: 476 - Pages: 2

Free Essay

Evaluate the Claim That Person Centred Therapy Offers the Therapist All That He/She Will Need to Treat Clients

...claim that Person Centred Therapy offers the therapist all that he/she will need to treat clients This essay will evaluate the claim that Person- Centred Therapy (PCT) offers the therapist all that he or she will need to treat clients. I will define PCT, its origins and the theoretical constructs and philosophical influences that set it apart from other psychological theories, as well as explore how its founder viewed personality development, and psychological disorders. I will then weigh up the strengths and weaknesses of PCT, drawing upon criticisms by other writers, in order to conclude whether or not it can be used as a stand-alone tool for all clients. Person-Centred Therapy is also know as Client-Centred Therapy, or the Rogerian approach after its founder, Carl Rogers (1902 – 1987), who was an influential American psychologist and one of the founders of humanistic psychology. Developed in the 1950s, PCT is a non-directive form of psychotherapy within the humanistic approach, which is itself often referred to as the third force of psychology – the first two being psychoanalysis and behaviourism. In addition to humanistic philosophy, Rogers was influenced by existentialism, or free will, and phenomenology, or human judgement and emotion. Self-actualisation: Person Centred Therapy centres around the belief that human beings have one basic tendency, and that is to “actualize, maintain and enhance” (Rogers, 1951, p487). Person-Centred Therapy is therefore based on this...

Words: 2857 - Pages: 12