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Unit 11 – Discussion Medications for Pain Management.
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Concerns about the use of opioids for pain management
Many parties are concerned about the use of opioids for pain management because that which makes them effective also makes them dangerous. Opioids work by binding to opioid receptors in the central nervous system and incite a pleasurable sensation while dulling pain when they bind to receptors in the brain. However, opioids have a pleasurable, tempting effect for some, and their continuous use has a high risk of leading to misuse, abuse, and eventual addiction. At higher doses, opioids can cause fatal heart rate and respiration slowdowns, whereas, at lower dosages, they may only make patients drowsy. Increased attention has been brought about by the increasing incidence of opioid use disorder and the related health effects. Opioids are useful for numbing pain, but they have a double-edged impact since they may also cause tolerance, physical dependency, and addiction.
Furthermore, opioid overdose has elevated to a serious public health emergency, grabbing the attention of governments and medical professionals everywhere. Because of the rising death rates associated with opioid overdoses, with over 75% of overdose cases related to opioids in 2021 (CDC, 2021), the U.S. government, in particular, has taken the lead in fighting the opioid crisis. The illegal usage of synthetic opioids like fentanyl has contributed significantly to the rise in opioid overdose mortality observed in recent years. The American government has responded by enacting several laws, tightening prescription regulations, boosting access to alternative medication, and expanding the availability of addiction treatment programs. These efforts indicate a thorough effort to address the many problems related to the use of opioids in pain treatment.
Article “America’s opioid crisis: the need for an integrated public health approach”
The article presents a timely and comprehensive understanding of the opioid crisis in the U.S. and the need for a comprehensive approach to address the crisis. I agree with the article’s overall premise of the vital necessity of implementing an integrated public health strategy to successfully address this issue, particularly in light of the ongoing rise in overdose fatalities and the fall in life expectancy. Notably, I also think it is necessary to use a collaborative approach across different disciplines, such as neuroscience, pharmacology, epidemiology, treatment services, and prevention, and to integrate interventions across diverse settings for a holistic response.
The article highlights four interrelated themes that encompass the essential elements of a successful public health strategy: bridging the gap between implementation science and practice, person-centered approaches for prevention and treatment, social determinants of health and disease, and using data to build learning systems of care. These topics highlight how important it is to address the intricate relationships between biological and social elements and how development affects brain function and sensitivity to outside stimuli. However, one aspect I would add to the article is to emphasize the role that the pharmaceutical industry, companies, and the drive for profit played in the development and severity of the crisis. It is well-documented that companies such as Purdue Pharma marketed opioids aggressively and had sale agents and sponsored doctors who pushed for more prescriptions; this started the cycle of addiction (Arteaga et al., 2021). Therefore, any comprehensive approach to address the opioid crisis requires new legislation that prevents companies from pushing prescriptions for profit.
Disorders commonly associated with patients who also need pain relief
The demand for pain relief and mental health concerns frequently coexist, complicating healthcare situations. Depression and chronic pain are commonly associated and co-occur with anxiety in people with chronic pain problems (Murez, 2021). Psychological and physical distress co-occurrence can intensify pain perception and impede efficient treatment. Because of the complex relationship that exists between depression and chronic pain, treating both conditions at the same time requires an integrated strategy. The co-occurrence of anxiety disorders and chronic pain issues is another significant correlation. Anxiety can cause increased pain sensitivity and intensify one’s subjective perception of pain (Harvard Health Publishing, 2021). Additionally, it may exacerbate avoidance habits, preventing patients from participating in physical therapy or other non-pharmacological pain relief techniques.
MME
The Morphine Milligram Equivalent (MME) is a standardized metric used in the healthcare industry to quantify the strength and equivalence of different opioid drugs and facilitate simpler comparisons of their effects. When opioid doses must be translated to a standard measure for safety, effectiveness, and regulatory considerations, the MME is very helpful in clinical practice and research. An opioid’s potency in relation to a standard, usually morphine, is represented by a conversion factor, which is applied to determine the MME for a particular opioid. A uniform metric helps assess and compare the various amounts of opioids patients are given, facilitating safer and more effective pain management.
Since MME gives medical providers a common standard to discuss and track opioid doses, it is crucial to reduce the dangers associated with opioid medication. Because it enables a more thorough assessment of a patient’s opioid regimen, this method also helps lower the risk of an opioid overdose. In addition to being beneficial for healthcare professionals, MME is also a crucial instrument for legislators, allowing them to create policies and rules that promote safer prescription practices.
References
Arteaga, C., Barone, V., Lleras-Muney, A., Reber, S., Maclean, C., Aslan, M., Kroft, K., Zarate, R., Weisburst, E., Van Effenterre, C., & Price, D. (2021).
The Opioid Epidemic: Causes and Consequences.
http://www.carolinaarteaga.com/s/Opioids_ArteagaBarone_Nov12.pdf
Blanco, C., Wiley, T. R. A., Lloyd, J. J., Lopez, M. F., & Volkow, N. D. (2020). America’s opioid crisis: the need for an integrated public health approach.
Translational Psychiatry,
10(1).
https://doi.org/10.1038/s41398-020-0847-1
Centers for Disease Control. (2021).
Understanding the epidemic | CDC’s response to the opioid overdose epidemic |.
https://www.cdc.gov/opioids/basics/epidemic.html
Murez, C. R. (2021).
Chronic Pain and Mental Health: The Empowered Patient’s Guide.
https://www.healthcentral.com/pain-management/chronic-pain-and-mental-health
Publishing, H. H. (2021).
Pain, anxiety, and depression. Harvard Health.
https://www.health.harvard.edu/mind-and-mood/pain-anxiety-and-depression
Stahl, S. M. (2021).
Stahl’s Essential Psychopharmacology.
https://doi.org/10.1017/9781108975292
