NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Analysis of Position Papers for Vulnerable Populations

Every demographic is impacted by the national opioid crisis, but no group is more so than veterans. Veterans are twice as likely to die from an opioid overdose than other Americans, according to study reports (Jones, 2020). As they are more prone to experience chronic pain, veterans are more vulnerable to developing an opiate addiction. Additionally, many veterans experience mental health issues including Post-Traumatic Stress Disorder (PTSD), which increases their desire to abuse alcohol and narcotics as a kind of self-medication (Jones, 2020). 

While there is a chance that all veterans will be more susceptible to addiction, some experiences—like multiple deployments, exposure to conflict, and body image issues—may make them more likely to abuse drugs (Jones, 2020). Military veterans continue to be severely impacted by the long-lasting public health crisis in the United States caused by opioid-related morbidity and death, with rates of overdose mortality among veterans rising by more than 50% between 2010 and 2021 (Bennett et al, 2022). It’s critical to place the present opioid issue within a larger social economic context when examining how it affects veterans and the current opioid problem. 

Examining the frequently complicated and unique sequencing of exposures to pain, stress, and pain treatment throughout the course of a person’s life cycle is necessary for a more thorough understanding of opioid-related overdose among veterans (Bennett et al, 2022). Many veterans engage in moderate to heavy alcohol use as part of their military obligations and leisure activities, and alcohol usage dramatically increases the risk of overdose when mixed with opioids (Bennett et al, 2022). 4,421 veterans died from an alcohol-related overdose between 2010 and 2021, according to a recent study that used VA records linked to National Death Index data (Bennett et al, 2022). As was to be expected, the vast majority of these deaths also involved opioids. 

Changes must be made to the way chronic pain is managed and to the way opioids are prescribed to enhance the services and results associated to opioid misuse among US Veterans (Bennett et al, 2022). Circuit training, Pilates, relaxation, and alternative therapies are examples of supplemental and collaborative care treatments that can be utilized to lessen and occasionally eliminate the consumption of opioid analgesics (Bennett et al, 2022). Utilizing non-pharmacological treatments may assist in lowering the quantity of veterans’ pain-management opioid prescriptions (Bennett et al, 2022). For the protection of their nation, courageous men and women put everything on the line. As a community, it is our duty to ensure that their lives are secure after they return home.

Role of the Interprofessional Team

On the opioid problem, not all medical providers share the same viewpoint. But to be resolved, the problem calls for the attention of every healthcare provider. It is recommended to adopt an effective interprofessional strategy to reduce opioid use among veterans (Hohmann et al, 2022). To reduce pain and decrease the prescription of opioids, prescription doctors, nursing staff, therapists, pharmacists, and mental health providers all have a major contribution (Hohmann et al, 2022). 

Rehabilitation therapists utilize nonpharmacological pain management techniques and social cognitive strategies (Hohmann et al, 2022). To provide a healthier approach to opioids, they might inform their patients about the advantages of therapy. Pharmacists are involved in monitoring and dealing with opiate consumption, addiction, and overuse (Hohmann et al, 2022). 

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Positions That Could Support the Approach to Improving Outcomes of care

Effective alternative therapeutic treatments for managing chronic pain are numerous. Considering there is a smaller risk involved than with pharmaceutical treatments, these alternatives should be investigated as the first therapeutic interventions (Kang et al., 2021). It has been demonstrated that trigger point therapy can reduce headaches as well as chronic back and neck discomfort. According to a survey performed on a veteran community, four sessions of acupuncture delivered within a year were linked to better effects and performance along with a 30% drop in the number of opiate prescriptions (Kang et al., 2021). 

Meditation and Qigong (an alternate form of yoga) are two examples of movement therapies that can be used to treat chronic pain without the use of drugs (Kang et al., 2021). Meditation has been shown in studies to reduce knee, cervical, and low back discomfort (Kang et al., 2021). Veterans participating in a clinical therapy program through telemedicine experienced improvements in their health, including relief from pain. Anxiety, irritability, and light-headedness can all be relieved by perception therapies, which include music therapy (Kang et al., 2021).  

The stances in this position paper are in favor of treating chronic pain in veterans without using opiates. Nonpharmacologic pain management techniques can lessen pain while also enhancing cognitive and social well-being (Kang et al., 2021). Such therapies address the individual instead of focusing on only the pain because many veterans experience post-traumatic stress disorder (PTSD) (Kang et al., 2021). In addition, since opiates cannot be prescribed to individuals for pain relief, they would not be at risk of abusing pain medications. 

Positions Contrary to Improving Quality Outcomes of Care

An educational seminar on the use of opioids in the management of chronic pain was held by the National Institutes of Drug Abuse (National Institute of Drug Abuse, 2022). Their stance on the subject is that opioids have a position in the reduction of pain. Over a five-year span, 108 million more pharmacological treatments for pain relief were issued. Adverse reactions and hospitalizations increased as a result of the rise in prescriptions (National Institute of Drug Abuse, 2022). However, 25–50% of those who suffer from chronic pain continue to receive inadequate pain care (National Institute of Drug Abuse, 2022). 

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

Two things that contribute to the incorrect use of opioids to treat chronic pain are untrained healthcare professionals and inaccurate online news accounts (Kirby et al., 2021). When patients ask for opioids to treat their pain, medical professionals and pharmacists frequently categorize them as substance abusers (Kirby et al., 2021). These presumptions influence their perception, making it impossible for the doctor to treat the patient effectively. Additionally, the media portrays opioids negatively, emphasizing on abuse, dependency, death, and illicit behavior (Taylor et al., 2019). They often neglect to mention the advantages for patients of using opioids for appropriate pain control. 

Although opioids have a negative impression, many veterans may benefit from them when used to treat chronic pain. Opioid prescriptions that are clinically necessary are at odds with initiatives aimed at reducing addiction and harmful consequences (Taylor et al., 2019). Nevertheless, this dilemma should not put an individual’s life quality in danger. Many report that feeling their pain is effectively maintained because they follow their prescription instructions (Wilson et al., 2021). Instead of trying to avoid prescribing opioids, the healthcare system must be reformed. The most effective methods for treating diverse levels of pain should be taught to healthcare professionals, not just the simplest ones. The correct use of opioids with the lowest possible danger and greatest possible benefit for patients is made possible by more information and instruction for these professionals (Wilson et al., 2021).

Conclusion

Pain management is challenging, specifically when opioids are used. It is unsafe to prescribe medications to a disadvantaged population, like Veterans, because of the risk of dependency and abuse (Jones, 2020). Many Veterans experience both extreme discomfort and mental health problems. Achieving the best results for this demographic requires finding alternatives to opiate painkillers (Jones, 2020). Alternative therapeutic treatments can be utilized to lessen or perhaps even eliminate the requirement for analgesics while treating chronic pain. 

NURS FPX 6026 Assessment 1 Analysis of Position Papers for Vulnerable Populations

References

Bennett, A. S., Guarino, H., Britton, P. C., O’Brien-Mazza, D., Cook, S. H., Taveras, F., Cortez, J., & Elliott, L. (2022). U.S. Military veterans and the opioid overdose crisis: a review of risk factors and prevention efforts. Annals of medicine, 54(1), 1826–1838. https://doi.org/10.1080/07853890.2022.2092896

Hohmann, L., Phillippe, H., Marlowe, K., Jeminiwa, R., Hohmann, N., Westrick, S., Fowler, A., & Fox, B. (2022). A state-wide education program on opioid use disorder: Influential community members’ knowledge, beliefs, and opportunities for coalition development. BMC Public Health, 22(1), 886-886. https://doi.org/10.1186/s12889-022- 13248-z

Jones, J. S. (2020). Opium slavery: Civil war veterans and opiate addiction. The Journal of the Civil War Era, 10(2), 185-212. https://doi.org/10.1353/cwe.2020.0025

Kang, H., Hunniecutt, J., Quintero Silva, L., Kaskie, B., & Bobitt, J. (2021). Biopsychosocial factors and health outcomes associated with cannabis, opioids and benzodiazepines use among older veterans. The American Journal of Drug and Alcohol Abuse, 47(4), 497- 507. https://doi.org/10.1080/00952990.2021.1903479

Kirby, T., Connell, R., & Linneman, T. (2021). Assessment of the impact of an opioid-specific education series on rates of medication-assisted treatment for opioid use disorder in veterans. American Journal of Health-System Pharmacy, 78(4), 301- 309. https://doi.org/10.1093/ajhp/zxaa386

National Institute of Drug Abuse. (2022). NIH launches harm reduction research network to prevent overdose fatalities. Retrieved from https://nida.nih.gov/news-events/news- releases/2022/12/nih-launches-harm-reduction-research-network-to-prevent-overdose- fatalities

Taylor, S. L., Hoggatt, K. J., & Kligler, B. (2019). Complementary and integrated health approaches: What do veterans use and want. Journal of General Internal Medicine: JGIM, 34(7), 1192-1199. https://doi.org/10.1007/s11606-019-04862-6

Wilson, M., Bray, B. S., Remsberg, C. M., Kobayashi, R., & Richardson, B. (2021). Interprofessional education on opioid use and pain identifies team-based learning needs. Currents in Pharmacy Teaching and Learning, 13(4), 429- 437. https://doi.org/10.1016/j.cptl.2020.11.011