Research Summary A patients’ history of substance abuse is often associated with increased opiate medication abuse after chronic pain management. Although psychological and rehabilitation programs emphasis self-management for chronic pain, it does not always lead to complete pain relief. For clients that are unable to manage their chronic pain, opiate medication can be an alternative way to relieve pain. In the article “Pain Medication Beliefs and Medication Misuse in Chronic Pain”, Schieffer et al. (2005) examines how opiate beliefs effects opiate medical use and abuse. The purpose of the study is to determine the relationship among risk factors for opiate abuse, current drug abuse, opiate effectiveness, and beliefs of the use of opiates. …show more content…
Determined hypotheses in this study were set up in three ways: 1) patients with a history of substance abuse would show higher rates of opiate misuse and decreased feelings of opiate effectiveness compared to others, 2) patients with a history of substance abuse will require more medication due to increased tolerance, preference for medication as treatment, and a belief for potential addiction to pain medications, and 3) a patient’s mood will reflect their current medication effectiveness and problems for substance abuse. Schieffer et al.
(2005) assessed 288 chronic pain patients that had a history of opiate use of a period over eight months at an outpatient VA pain clinic. On average, participants aged 54.8 years old ranging from 25-88 with 93% resulting in males and 7% in females. Common pain diagnoses were indicated as back pain, neck pain, extremity pain, headaches, neuropathic pain, and other. For assessments, each client completed a Hospital Anxiety and Depression Scale (HAD), Oswestry Disability Index 2.0, Prescription Drug Use Questionnaire, Pain Intensity and Relief Assessment, Medication Beliefs Self-Report, and Substance Abuse and Psychiatric History report at the initial visit with examination of their medical records. The assessments indicated the participants’ anxiety and depression levels, pain levels, beliefs of medication use, and history of reported substance abuse with opiate …show more content…
drugs. The findings of study reported 48% of patients had a history of substance abuse with 11.5% being associated with just substance abuse as a psychiatric problem while 35.7% had another co-occurring disorder. Patients with a history of substance abuse was related to a higher rate of medication abusive behaviors later. Medication use also increased for patients with substance abuse history and psychiatric disorders; however, there was no difference between those whom had a substance abuse and those whom did not towards differences in medication effectiveness or the amount of medications prescribed. With increased substance abuse history or potential, Schieffer et al. (2005) reported that there were higher levels of anxiety, need to stop activities due to pain, and a greater belief of substance abuse potential. Research Critique Introduction Schieffer et al.
(2005) clearly identified the purpose of the study was to evaluate the influence of medication beliefs, pain symptoms, mood, substance abuse history, and psychiatric history. This focus portrayed the need to analyze risk factors for medication misuse and potential substance abuse. The specific hypotheses of this study were stated by Schieffer et al. (2005) by “…to test the following specific hypotheses…” (p. 622) and listed three aspects that the researchers were interested in. The introduction provided a clear opportunity for the researchers to state the purpose of the study and key aspects needed for further
examination. Literature Review In the article, “Pain Medication Beliefs and Medication Misuse in Chronic Pain”, Schieffer et al. (2005) included their literature review in the introduction. The research provided indicated the increase of opiate medications as a long-term treatment plan for chronic pain and substance abuse occurrences for opiate users. Previous research studies were used that evaluated behavior risk factors for substance abuse and the misuse of opiates for chronic pain history. The research reported that specific drug behaviors included aggressive communication, drug hoarding, and requests to specific drugs. Another study stated that patients with substance abuse history were more likely to increase their chances of misusing pain relieving medication. Most of the research review provided in this study last ten years; however, there was a research review that dated back to 1983. With a wide-range of dates of the included literature review, the current researchers understood the lack of knowledge towards patients’ beliefs on opiate medication, issues for substance abuse history, and mood states towards problematic medication use. The researchers aimed to indicate how an individuals’ substance abuse history, belief on medication, and current mood would affect their future drug misuse with opiates. Methods The methods section indicated that there were 288 patients referred from an outpatient VA multidisciplinary pain clinic with a period of 8 months or more opiate use. Patient demographics were displayed in Table 1 of the article and showed mean age, gender, marital status, employment status, and pain diagnoses. These details gave a greater understanding of the type of participants in the study and their background detail. For the assessments, the researchers clearly described each assessment used to evaluate patient’s previous drug abuse, disabilities, anxiety and depression, prescription drug use, pain evaluation, medication beliefs, and psychiatric history. Each assessment was stated and describe to indicate their purpose in the study. Results In the research, results were clearly stated through sections based on the tests provided in the methods section; there was also a clearly labeled pie chart in Figure 1 to show the percentage of patient diagnoses for psychiatric and substance abuse disorders. The research reported that 48% of the patients had a prior drug history with 35.7% having a substance abuse and psychiatric problem. It was also reported that there was no difference between substance abusers and nonsubstance abusers towards effectiveness of medications and types of opiates given; conversely, substance abusers were more likely to endorse the beliefs that pain medication works effectively for pain control, improve moods, and there is a need for higher doses. A history of substance abuse, psychiatric diagnosis, and pain reduction through opiate medication reported an increase in drug misuse. Discussion Schieffer et al. (2005) indicated the value of this research is to understand the risk factors for opiate substance abuse and the effectiveness of opiate treatment. However, there are limitations in the study such as a limited focus on only VA patients and the use of self-assessments to determine risk factors, pain evaluation, and history of substance abuse. These limitations were discussed at the end of the discussion section, but indicated the helpful information this study provides towards patients with substance abuse and the likelihood of an effective use of opiate medication for chronic pain.
The documentary states that over 27,000 deaths a year are due to overdose from heroin and other opioids. According to the Center for Disease Control and Prevention in 2015 prescription pain relievers account for 20,101 overdose deaths, and 12,990 overdose deaths are related to heroin (Rudd et al., 2010-2015). The documentary’s investigation gives the history of how the heroin epidemic started, with a great focus on the hospice movement. We are presented with the idea that once someone is addicted to painkillers, the difficulty in obtaining the drug over a long period of time becomes too expensive and too difficult. This often leads people to use heroin. This idea is true as a 2014 survey found that 94% of respondents who were being treated for opioid addiction said they chose to use heroin because prescription opioids were “more expensive and harder to obtain (Cicero et al., 2014).” Four in five heroin users actually started out using prescription painkillers (Johns, 2013). This correlation between heroin and prescription painkiller use supports the idea presented in the documentary that “prescription opiates are heroin prep school.”
Almost one hundred years ago, prescription drugs like morphine were available at almost any general store. Women carried bottles of very addictive potent opiate based pain killers in their purse. Many individuals like Edgar Allen Poe died from such addictions. Since that time through various federal, state and local laws, drugs like morphine are now prescription drugs; however, this has not stopped the addiction to opiate based pain killers. Today’s society combats an ever increasing number of very deadly addictive drugs from designer drugs to narcotics to the less potent but equally destructive alcohol and marijuana. With all of these new and old drugs going in and out of vogue with addicts, it appears that the increase of misuse and abuse is founded greater in the prescription opiate based painkillers.
Have you ever wondered why when you stub your toe on the chair in the living room, it helps tremendously to yell out an expletive or two and vigorously rub the area? I may not be able to discuss the basis for such language in this paper, but we will explore the analgesic response to rubbing that toe, in addition to the mechanism of pain and alternative treatments such as acupuncture and transcutaneous electrical nerve stimulation.
Although writing a prescription may be an easy way to put a bandaid on a problem, people tend to forget that medication can’t be responsible for curing our nation. Slowly we are becoming a country where pills are handed out like candy, causing a severe series of negative effects and downfalls. Ray Bradbury, the author of the award winning novel Fahrenheit 451, is definitely in agreement. In 1951, when the novel was written, Bradbury was able to make the prediction that the innocent use of medication would soon turn into an extreme drug epidemic, and unfortunately he wasn’t wrong. The overuse of drugs in the United States, such as mental illness medication
By the year 2000 opioid medicine containing oxycodone etc., are being abused and misused and more than doubled in 10 years’ time.
According to CDC in the year 2015 opioids played a part in 33,091 deaths. Now you may ask what an opioid is. An Opioid is a compound that binds to opioid receptors in the body to reduce the amount of pain. There are four main categories of opioids, one being natural opioid analgesics including morphine and codeine, and semi synthetic opioid analgesics, including oxycodone, hydrocodone, hydromorphone, and oxymorphone. The second category being methadone, a synthetic opioid, the third category being synthetic opioid analgesics other than methadone includes tramadol and fentanyl. The last category is an illicit opioid that is synthesized from morphine called heroin.
In medical school/pharmacology school, medical professionals are taught to treat severe pain with opioids. However, opioids should be prescribed with the possibility of future dependency in mind. Physicians often struggle with whether they should prescribe opioids or seek alternative methodologies. This ethical impasse has led may medical professionals to prescribe opioids out of sympathy, without regard for the possibility of addiction (Clarke). As previously stated, a way to address this is use alternative methods so that physicians will become more acquainted to not not treating pain by means of opioid
Wilkes, E, Gray, D, Saggesr, S, Casey, W & Stearne, A 2010, ‘Substance Misuse and Mental Health
This leads to the second school of thought on medically assisted treatment. There has been a great deal of debate about the medication used to treat Opiate addiction, methadone. Many feel that the drug methadone is simply trading one drug in for another, as the addiction to methadone is quick and almost more powerful than an opiate addiction (Nelson, 1994). The withdrawals effects are far more intense with methadone and for this reason it is a lifetime maintenance medication. Some suggest that more rehabilitative programs are needed that would address the social problems the users have to help them recover, instead of the methadone program that is viewed...
Almost everybody on Long Island, and probably all around the world, has been prescribed a drug by a doctor before— whether it was to knock out a nasty virus, or relieve pain post injury or surgery. However, what many people don’t realize is that these drugs can have highly addictive qualities, and more and more people are becoming hooked, specifically teenagers. But when does harmlessly taking a prescription drug to alleviate pain take the turn into the downward spiral of abuse? The answer to that question would be when the user begins taking the drug for the “high” or good feelings brought along with it—certainly not what it was prescribed for (1). The amount of teens that abuse prescription medications has been rapidly increasing in recent
Marion Good, PhD, RN, has focused her study, “A Middle-Range Theory of Acute pain Management: Use in Research,” on complementary medicine for pain and stress, acute pain, and stress immunity. The purpose of this theory is to put into practice guidelines for pain management. Good, 1998, noted the need for a balance between medication usage and side effects of pain medications. The theory also promoted patient education related to pain management following surgery and encouraged plan development for acceptable levels of pain management. This theory was developed through deductive reasoning. Chinn & Kramer, 2008, defined deductive reasoning as going from a general concept to a more specific concept. Good, 1998, related that there was a balance between analgesia and side effects in which two outcomes can be deduced: (1) a decrease in pain, and (2) a decrease in side effects. These outcomes can be studied further or more detailed concepts can be deduced from them.
As I’m sure you would agree, doctors have to stop over prescribing their patients with opioids. Although opioids are used as pain medication and are prescribed more to patients who are fresh out of surgery or have chronic pain, it can become highly addictive. According to the National Survey on Drug Use and Health, about 11.5 million people have misused the opioids they were prescribed(Thompson). Their misuse can be due to the fact that their doctors are prescribing them a ridiculous amount of opioids, instead of just giving them regular ibuprofen. It doesn’t matter how well these drugs are working, what matters is how it’s affecting the patients who are given this deadly drug. Clearly doctors aren’t taking into consideration at all the
Meera, A. (2011). Pain and Opioid Dependence: Is it a Matter of Concern. Indian Journal Of
Central Idea: Prescription drugs can cause serious mental and physical health problems if they are taken incorrectly or abused.
The use of drugs is a controversial topic in society today. In general, addicts show a direct link between taking drugs and suffering from their effects. People abuse drugs for a wide variety of reasons. In most cases, the use of drugs will serve a type of purpose or will give some kind of reward. These reasons for use will differ with different kinds of drugs. Various reasons for using the substance can be pain relief, depression, anxiety and weariness, acceptance into a peer group, religion, and much more. Although reasons for using may vary for each individual, it is known by all that consequences of the abuse do exist. It is only further down the line when the effects of using can be seen.