On August 25, 2016, the Surgeon General issued a letter to physicians urging them to take a part in combating the opioid epidemic. On the Surgeon General's website, healthcare providers are encouraged to help solve the opioid epidemic:
"Our nation faces an opioid crisis. Health care providers are uniquely positioned to help communities and their patients #TurnTheTide on the opioid epidemic. Providers can be the solution. Join the movement. Sign the pledge."
To gauge how clinicians felt about the Surgeon General's recommendations to fight the opioid epidemic, the Physician-Patient Alliance for Health & Safety (PPAHS) conducted a survey to examine perceptions about the Surgeon General's appeal. To read PPAHS' full report on the survey, please click here.
The responses give a snapshot of doctor's perspectives on possible causes for the 'opioid epidemic' and - most importantly - views on who should play roles as change leaders. However, both the Surgeon General's letter, as well as the PPAHS' survey, focuses on only a single, albeit important, stakeholder. What about nurses? What role should nurses play in this fight against the opioid epidemic?
Who Should Lead the Fight?
When asked the question: "Who do you believe should lead the fight against the opioid epidemic?", the responses pointed clearly to doctors. More than 2/3 (68.8%) of physician respondents said their profession should lead the fight. That is compared to the 18.8% who said the government should lead the fight against the opioid epidemic and 12.5% who said local communities should be in charge.
Taken in a greater context, the onus for change needs to stem from a clinical and hospital setting - including doctors, administrators, and of course, nurses.
Nurses share the lynchpin responsibility for curbing opioid harm. According to an article by Ruth Tarantine, DNP, RN, Advanced Practice Registered Nurses (APRNs), and Nurse Practitioners are the third largest opioid prescribing group for individuals with Medicare Part D. 1
What Tools are Needed?
There was a strong call from respondents for additional tools, particularly greater education in effective pain management. Eighty-five percent called for physicians themselves to receive better education on safely and effectively treating their patients' pain. Better screening of patients at risk for opioid-use disorder and connecting such patients to evidence-based treatment programs was on the wish list for approximately 3/4 of survey takers. And 66% believe the conversation needs to be changed from talking about opioid addiction as a chronic, medical condition, not a moral issue. (Respondents could select multiple tools)
Numerous nursing organizations have called for similar tools. The American Nurses Association has released a statement asking for ways to enable nurses to play an expanded role. This includes greater access to medication-assisted treatment, extended education and training for prescribers, and an increased awareness of Prescription Drug Monitoring Programs (PDMPs).2
There is no question that opioid-related harm is a universal patient safety concern. It's a complex problem that requires a network solution across disciplines. It requires cooperation between doctors, nurses, governmental organizations, and local communities.
For more on this topic, download our corresponding infographic Healthcare Professionals Attitudes Towards Opioids.
1.Taratine, R. "How Nursing is Helping to Combat the Opioid Epidemic." The Huffington Post. June 23, 2016. http://www.huffingtonpost.com/ruth-tarantine-dnp-rn/how-nursing-is-helping-to_b_10637130.html
2. Nursing's Role in Addressing the Nation's Opioid Crisis. American Nurses Association. http://nursingworld.org/DocumentVault/GOVA/Health-System-Reform/Nursings-Role-Opioid-Crisis.pdf
Michael Wong is executive director, Physician-Patient Alliance for Health & Safety and Nicholas Wong is director, patient safety analytics, Physician-Patient Alliance for Health & Safety