Nursing and Fighting the Opioid Epidemic

Fortunately, medical professionals and organizations are working hard to solve this growing problem.

The opioid epidemic in the United States is a serious public health concern. According to the U.S Department of Health and Human Services, 2.1 million Americans had an opioid disorder in 2017, and 47,600 Americans died from opioid overdoses.

Death and illness aren't the only burdens of the opioid crisis. Opioid addiction takes a heavy toll on individuals and families, not to mention the country's economy; a 2017 report from the Council of Economic Advisers notes that the epidemic cost the U.S. $504 billion in 2015. And prescription drug misuse can lead to addiction to illegal opioids like heroin and illicitly manufactured fentanyl; the National Institute on Drug Abuse estimates that about 80 percent of heroin users first misused prescription opioids.

Nursing and the opioid epidemic.

Opioids were first prescribed to alleviate pain. But increased prescription of opioid medications led to widespread misuse of both prescription and non-prescription opioids before it became clear that these medications were highly addictive, according to the National Institute on Drug Abuse.

Nurses are on the front lines of the opioid epidemic. The American Nurses Association has identified several ways in which registered nurses and advanced practice registered nurses are working to help patients at risk for opioid abuse and their families. These include:

• Providing education about opioid use at the time of prescription, including how to take the drug safely and how to dispose of any unused medication.
• Encouraging, where appropriate, the use of alternative therapies for pain control, such as hot or cold therapy, massage, distraction, or meditation. RNs and APRNs can also advocate for or prescribe physical therapy, regional pain control, surgery, complementary medicine practices, or less addictive pain relievers as an alternative to opioids.
• Learning more about the signs of opioid addiction and helping to identify at-risk individuals, especially in maternal-fetal medicine and school settings.
• Following the directive from the Surgeon General and carrying reversal agents such as naloxone, which can potentially save the life of someone who has overdosed on opioids.

Fighting the opioid epidemic through collaboration.

Collaboration among medical professionals—pharmacists, physicians, mental health professionals, governmental agencies, even insurers and student professionals—is important to the success of any public health initiative. Three major coalitions draw on nurses' and other medical professionals' experience to share knowledge, increase awareness, and develop successful strategies to combat the opioid epidemic:

• The National Academy of Medicine Action Collaborative on Countering the U.S. Opioid Epidemic is one of the largest committees formed to develop strategies to reduce opioid misuse and improve outcomes for patients and families affected by opioid misuse. Comprising more than 125 organizations, the collaborative is focused on educating and training health professionals, developing prescription and evidence standards, accelerating the dissemination of best practices and integrated approaches to treatment, and encouraging research into the opioid epidemic. Nurses work with public- and private-sector professionals to catalyze action on these priorities and develop and share solutions.
• The Coalition to Stop Opioid Abuse advocates for government legislation to combat the opioid epidemic. Its agenda includes initiatives to challenge the stigma around substance abuse, removing barriers to treatment and recovery services, increase funding for insurance coverage for substance abuse treatment, and support research for effective treatments for both substance abuse disorders and chronic pain conditions. With the American Academy of Nurse Practitioners on its steering committee, this coalition works with nurses to end the opioid crisis.
• The Mental Health Liaison Group is dedicated to elevating the national conversation around mental health and addiction. With more than 60 member organizations, the coalition works to influence federal policies that support the prevention of, early intervention into, and treatment and recovery from substance abuse disorders. By drawing on the expertise of nurses and other medical professionals, the group provides information on best practices to members of Congress and aims to help increase funding to important intervention programs.

Nurses are vital to each of these groups, and their expertise and firsthand knowledge of patients inform their advocacy—and sometimes federal policy.

Nursing and the opioid epidemic will continue to converge until the crisis has abated. Through education, training, advocacy, collaboration, and a patient-centric approach, nurses and other medical professionals can save lives.