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Running head: OPIOID EPIDEMIC 1

Opioid Epidemic

Name

Institution

OPIOID EPIDEMIC 2

Opioid Epidemic

Introduction

The Hippocratic Oath, a promise to inflict no harm to patients, is taken by all physicians.

Physicians must take numerous of factors into consideration before deciding what the best

treatment for his or her patients might be. In the last 15 years, many physicians have contributed

to the problem, the pervasive opioid epidemic, instead of the solution. According to Morbidity

and Mortality report from the Center for Disease Control (CDC), more than half a million

Americans have died from drug overdoses, and more than 60% of those deaths involved an

opioid, which included prescription opioids (Rudd, Seth, David, & Scholl, 2016). The number of

opioids prescribed in the United States nearly increased fourfold in the last 15 years. Opioids

include morphine, oxycodone (OxyContin), hydrocodone, codeine, methadone, hydromorphone

(Dilaudid), oxymorphone (Opana, Opana ER), and levorphanol (Levo-Dromoran) (Lewis,

Bucher, Dirksen, Harding, &Heitkemper, 2014, p. 124). Opioids are narcotics that are prescribed

to relieve both acute and chronic pain. For the most parts, they are considered safe when used

appropriately and taken only for a short period. When used regularly, opioids can lead to

tolerance and dependence which can then result in overdose and even death. Prescription pain

relievers have contributed to the opioid epidemic and the increase in opioid overdose deaths in

the United States. The pain relievers should only be prescribed for short-term use except for

those undergoing active cancer treatment, palliative care, and end-of-life care. This paper will

discuss how prescription pain relievers have contributed to the opioid epidemic while utilizing

ethical theory and principles, faith integration, and value to the nursing profession.

OPIOID EPIDEMIC 3

Background

The history of opioid crisis or epidemic is dated back from the 1980s. This addiction,

which has affected many American, is majorly caused by prescription of painkillers that grew to

219 million per year between 1991 and 2001. Many health practitioners have engaged

themselves into the prescription of drugs that are more powerful than morphine, the

recommended pain medication. A report from CDC shows that by 2002, 17 percent of patients

who were being administered to painkillers took more powerful drugs than morphine (Fields,

2011). In 2012, the number increased to 34 percent. Many people across the world continue to

use opiates (opioid painkillers) as analgesic agents. They treat trauma, burns or surgeries, and

this call for a short-term use. The abuse of these drugs comes into action when used for a long

time to manage terminal diseases such as cancer because the drugs have effects of reducing

anxiety and producing mild sedation (Fields, 2011). The effects magnify when opiates are used

for long time, and this is why they are recommended for a short-term use. When used for a short

time and appropriately, drug addiction cease to exist; however, many long-time users get

addicted and suffer from respiratory depression, a cause of death from opiates.

All painkillers are known for one purpose, that is, to reduce pain on the affected

individuals. It is, however, amazing that many people not only use them for pain relief, but also

to enjoy the euphoric feeling they give (Nelson, Juurlink, & Perrone, 2015). With lots of naivety,

many people have become addicted to such drugs without knowing their impacts. Some go ahead

even to consume more than the prescribed painkillers. Some nurses have also been at the

forefront in promoting overdose of such drugs by providing more than the doctor's prescription

to satisfy the interest of the patient. This has posed many questions about the integrity of nurses

in exercising their professionalism. Many doctors have also promoted overdose of opioids as a

OPIOID EPIDEMIC 4

way of showing compassion to those patients who are living with unbearable pain . The act of

compassion currently leads to many deaths out of preventable opioids epidemics. Such doctors

who offer who prescribe more than required drugs work against their institution that mandates

them to save life rather than promoting deaths. Some other factors that promote the rise in the

number of painkillers prescribed by the doctors include cultural beliefs and medical disability

scenarios. The cultural song that painkillers are quick relievers of pain has made many people

call for more drugs speed up their relief (Nelson et al., 2015). Some medical disabilities

scenarios make families venture into the continuous intake of painkillers to save income that

would be heavily spent in hospitals as treatment bills. The drugs such as Vicodin are also readily

available through online pharmacies without prescriptions providing an open gate to large sales

(Fields, 2011). Dealing with addiction has been a big challenge since there is no set

infrastructure to help doctors treat it. Many insurance companies are also not ready to pay for

such medications; therefore, the space for opioids addiction is still open and the number of those

affected increase day by day.

Argument

One of the heating arguments on use of opioids is whether the significant negative

impacts arise due to long-term use. This has led to a struggle whether doctors should prescribe

the drug for long time treatment since one side of the arguing parties believe that long-term use

is associated with addiction. The other side claims that whether it is administered for short-term

or long-term, morals and ethics should be considered to reduce its effects (Fields, 2011).

Many people living in different states have considered the massive migration of doctors

from physician-owned practices into incorporated healthcare institutions to be the cause of this

epidemic (Bewel, 2017). The doctors' practices in the healthcare organizations are controlled by

OPIOID EPIDEMIC 5

the certain rules set by individual health centers. However, other parties still claim that the

fundamental cause of the rise in abuse of opioids is negligence on the ethics and code of conduct

in the medical profession. Many doctors, although may be compelled to prescribe more drugs,

have not committed themselves to the principles that guide their performance in providing

healthcare to the public. They do not provide the patients with reasons behind recommending

the use of opioids for a short period rather than using it for end life treatment. Many health

programs have not included the community and other stakeholders leading to poor strategies of

administering treatment.

Opposing Position

As many drug abusers would oppose, the increase in the cost of opioids would be the best

solution to reducing opioid epidemic and the drug be prescribed only for short-term use. The

public should also stand firm and accept a policy on the introduction of reverse treatments such

as use of naloxone. Naloxone is a drug that can reverse both opioid pain reliever and heroin-

induced overdoses (Nelson et al., 2015). The drug is easy to administer and therefore would

require just a basic training to non- medical personnel. The drug is cheap, has a long lifespan,

and one cannot abuse it because it has no addictive effect. Application of beneficial treatments

such as psychotherapy and physiotherapy would be more important compared to the use of

opioids that are characterized with many health hazards. A position that may not favor many

medical practitioners is to sentence anyone found guilty of prescribing excess drugs.

Standards of Practice/Code of Ethics/Social Policy Statement Integration & Clinical

Practice Application

In any field of profession, the code of ethics and standards of practice are fundamental in

providing a quality output. The aspect of making rational, ethical, and practical decision on the

OPIOID EPIDEMIC 6

use of opioids is essential in handling patients with chronic pain. Many people had always

determined the use of opioids in medicine with fearful attitudes and politics. A number of factors

including strong regulation of the manufacture, sales, and prescription of the drugs had been used

to enhance the high level of ethics concerning medical practice. Currently, the drug, being legal,

is left in the hands of nurses, patients, and medical centers leading to high rate of abuse. One of

the ethical obligations of health physicians is to be good and show much of their interests to

patients. The moral concept of nonmaleficence provides that doctors do no harm to patients

(Nelson et al., 2015). They should evaluate the benefits and risks of specific treatments and

implement one that suits the patient with no harmful impacts. The physicians, especially

emergency physicians, need to be strong advocates for patients. They should consider the verbal

communication from the patient about the intensity of pain before administering any opioid

medication. Many patients have faith in the services that the physicians offer hence they should

build that trust by providing quality and standard services.

Value to Nursing Profession

The high number of deaths due to opioid emergency continues to devalue the nursing

profession. Many doctors have been at the frontline in prescribing excess drugs that lead to

addiction. Lack of professional ethics and code of conduct is evident in many medical

practitioners reducing the trust of the nurses on the international scale. Many physicians continue

to apply the virtue of compassion resulting in overdose of painkillers. They fail to discuss with

their patients about the effects of some medical treatments leading to lots of regrets to patients at

the time of health complications. Although 87 percent of nurses do not fear opioid, a large

number of them have negative attitudes towards patients with a history of drug abuse (Fields,

2011). Such attitudes deter their relationship with patients leading to suboptimal patients care.

OPIOID EPIDEMIC 7

Conclusion

The abuse of prescription opioids is a growing problem in different states. The patients,

physicians, and pharmacies must know that they are responsible for the opioid epidemics. Many

people will continue to die if the responsible parties do not work towards mitigating such abuses.

The physicians must take the largest share in reducing opioids overdose by practices good ethics

in their profession especially administering the drug for short-term use rather than long-term

treatments.

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References

Bewel. (2017). Prescription drugs: The epidemic of addiction in the US. Retrieved on June 10,

2017 from https://neuroscience.stanford.edu/news/prescription-drugs-epidemic-addiction-

Fields, H. L., (2011). The Doctor’s Dilemma: Opiate analgesics and chronic pain. PMC Journal,

69 (4), 591-594. DOI: 10.1016/j.neuron.2011.02.001

Lewis, S. L., Bucher, L., Dirksen, S. R., Harding, M. M., Heitkemper, M. M., (2014). Medical-

Surgical nursing (9

ed.) St. Louis, MO: Mosby-Elsevier.

Nelson, L. S., Juurlink, D. N., & Perrone, J. (2015). Addressing the opioid

epidemic. Jama, 314(14), 1453-1454.

Rudd, R. A., Seth, P., David, F., & Scholl, L. (2016). Increases in drug and opioid-involved

overdose deaths — United States, 2010–2015. Morbidity and Mortality Weekly Report,

65 (50-51) 1445-1452. DOI: 10.15585/mmwr.mm655051e1

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