Nurses play a critical role in the opioid epidemic. That’s because registered nurses (RNs) and licensed practical nurses (LPNs) are on the frontline in monitoring patients' pain and deciding whether they need pharmacologic pain relief. And since opioids are the most commonly prescribed drugs for pain management in hospitals, nurses need to be acutely aware of the risks and safe use of opioids while monitoring for signs of addiction and overdose.
Needless to say, there is a delicate balance between prescribing adequate pain medication to help patients manage their pain and facilitating a dependence on opioid pain medications. Consequently, licensed nurses who prescribe and treat patients with opioids must be equipped to manage acute pain and screen for signs of addiction. Moreover, all nurses should be highly educated on both federal and state requirements for prescribing controlled substances.
What Is an Opioid?
Opioids are controlled substances that produce morphine-like effects. They are extremely effective in preventing and managing moderate to severe pain. Furthermore, opioids can produce a feeling of euphoria and/or intense drowsiness. When used in excess (or abused), opioids can cause difficulty breathing, nausea and vomiting, dizziness, headaches, and confusion. In extreme cases, opioid misuse can lead to a fatal drug overdose.
Today, the most commonly prescribed opioids for pain management are the following:
- Oxycodone (OxyContin)
- Hydrocodone (Vicodin)
- Oxymorphone
- Codeine
- Morphine
- Fentanyl
Opioids are prescribed to treat short-term pain. However, some opioids may be prescribed to treat long-term chronic pain. In either case, prescription opioid misuse can turn into addiction.
What’s more, taking prescription opioids for a long period of time can cause a patient to build up resistance to the drug, requiring a person to take more than intended in order to feel its effects. Overconsumption of opioids can have devastating consequences, including heavy addiction, unintended overdose, and death.
Is Valium an Opioid?
Valium is not an opioid. Valium, which is a popular brand of diazepam, is categorized under benzodiazepine medications and can be used to treat anxiety, seizures, and alcohol withdrawal. In addition, valium may be prescribed to a patient before a medical procedure to reduce muscle spasms and provide sedation.
Diazepam works by increasing the effects of a neurotransmitter called GABA, an inhibitory chemical messenger that helps slow down activity in the brain and calm the nervous system. It’s a powerful drug that, like opioids, should be prescribed with caution and care. Likewise, nurses with full prescriptive authority who can administer valium without physician oversight should know the advantages and drawbacks of prescribing controlled substances.
Controlled Substances: Recognizing the Need for Action
Registered nurses and advanced practice registered nurses (APRNs) will undoubtedly be required to administer opioids to patients during their careers. In fact, the U.S. healthcare system is uniquely positioned as both a contributor and solution to opioid misuse. Based on data from the CDC and as stated by The National Institute on Drug Abuse:
“Opioid-involved overdose deaths rose from 21,089 in 2010 to 47,600 in 2017 and remained steady through 2019. This was followed by a significant increase in 2020 with 68,630 reported deaths and again in 2021 with 80,411 reported overdose deaths.”
In response to the startling opioid crisis, on October 21, 2015, former president Obama declared an effort on a federal, state, and private sector level to ensure that opioid prescriber training would be accessible and/or obligatory for healthcare professionals who prescribe controlled substances. Subsequently, according to the American Nurses Association (ANA), more than 540,000 healthcare providers agreed to finish opioid prescriber training within two years.
What Is a Controlled Substance CEU for Nurse Practitioners?
Opioid prescriber training, also called controlled substance continuing education units (CEU) for nurse practitioners (NPs), is a continuing education course focusing on prescribing, administering, and managing controlled substances. It’s designed to ensure that nurse practitioners have the knowledge and skills to prevent misuse and addiction and spot any risks associated with controlled substances.
These courses are typically mandated by state licensing boards for nurses, such as RNs or APRNs, who will have prescriptive privileges within the medical arena. Generally, controlled substance CEU classes involve a three to six contact-hour educational course that addresses the following components:
- Appropriate pain management and prescribing practices
- Signs of abuse or misuse of controlled substances
- Guidance on implementing appropriate intervention when necessary
Some contact hours for a pain management CEU are free or low cost. Additionally, specific criteria and material will likely vary between controlled substance CEU courses. Depending on where a nurse chooses to practice, it’s essential to check what each state requires for continuing education for nurses who will have prescriptive privileges.
Faces of Fentanyl
While nurses continue to play a vital role in effective and safe pain management practices for patients, the U.S. is still fighting against an opioid epidemic. As a matter of fact, in recent years, a synthetic opioid called fentanyl has defined the opioid crisis. Fentanyl is a highly-addictive opioid, and it contributed to 67,325 preventable deaths in 2021. Most overdoses are caused by fentanyl abuse, which now kills more people than firearms and traffic accidents combined.
A Nurse's Role in Overdose Recovery
Opioids can be extremely effective for pain management, but they also carry a risk of addiction and abuse. Therefore, healthcare providers are advised to use opioids prudently and follow the best practices for prescribing and monitoring these medications. In addition, nurses who administer controlled substances should be meticulously aware of the correct dosage amounts, as patients may not always accurately report their pain level.
For example, overprescribing popular opioids such as oxycodone could lead to an oxycodone overdose if a nurse is unfamiliar with the strength and recommended dosage of this class of opioid. Additionally, nurses should be able to educate patients about the risks of opioid use to help ensure they take the appropriate dose.
Finally, a nurse needs to know the signs of opioid overdose and be quick to act. This action may include the administration of naloxone, an opioid antidote that acts as an emergency treatment for opioid overdoses, and follow-up treatment with medication-assisted treatment (MAT), along with counseling for opioid use disorder.
See also: Are Nurses Happy? Do They Find Their Jobs Meaningful?
Do I Really Want to Become a Nurse?
Some say that being a nursing professional is one of the hardest jobs out there. Every day, nurses care for patients and decide how to treat them. The current opioid crisis adds extra pressure on nurses to make life-changing decisions for patients. As a result, some nurses will experience burnout from repeated exposure to difficult situations. Moreover, aspiring nurses or new nurse graduates may ask, “Do I really want to become a nurse?”
The reality is that being a nurse is challenging. Yet, at the same time, nurses have the opportunity to make a difference in people’s lives. Plus, nurses can become patients’ advocates and serve as their voices during vulnerable times. Now, more than ever, the opioid crisis needs nurses who can identify opioid addiction and offer nonjudgmental and empathetic support to those who are struggling.
Have you decided to take part in this noble profession? Learn about the top 10 best nursing schools in the U.S. here!
