Nursing viewpoints on opioid crisis

Reviewed by James Ives, M.Psych. (Editor)Sep 6 2018

Addictions nursing specialists have a unique role to play in caring for patients, families, and communities affected by the crisis. A series of original research and expert commentaries provide the nursing specialist's perspective on the opioid crisis, appearing in the July/September special issue of Journal of Addictions Nursing (JAN), the official journal of the International Nurses Society on Addictions (IntNSA). The journal is published in the Lippincott portfolio by Wolters Kluwer.

"The opioid crisis is at the forefront of the US and global drug use problem conversation," writes JAN Editor-in-Chief Christine Vourakis, PhD, RN, FIAAN, FAAN, in an introductory editorial. "The Journal of Addictions Nursing is adding its contribution to the literature to offer a nursing perspective in addressing this international scourge."

Nursing Research and Viewpoints on the Opioid Crisis

The special issue presents seven original research papers understanding and addressing the needs of people with opioid abuse and opioid abuse disorder. The papers were selected by two eminent clinicians and educators who served as Guest Editors of the special issue: Ann M. Mitchell, PhD, RN, AHN-BC, FIAAN, FAAN, of University of Pittsburgh and Diane Snow, PhD, APRN, BC, PMHNP-BC, FAANP, FIAAN, of University of Texas, Arlington.

In a Guest Editorial, Dr. Mitchell introduces the seven studies - drawing attention to the "numerous programs and treatment options that are available to impact the overdose and mortality rates among persons who use opioids." The research topics include:

• Unique insights into the unmet social support needs of Iranian women undergoing methadone maintenance therapy for OUD.
• Integrating information on medication-assisted treatment and other evidence-based therapies for OUD into the graduate nursing curriculum
• A review of evidence showing the effectiveness of the "rescue" medication naloxone to prevent fatal overdose among people who use opioids
• A program to educate emergency department personnel about their state's prescription drug monitoring program, including its impact on opioid prescribing rates
• The benefits of screening for adverse childhood experiences among individuals with substance abuse disorders enrolled in a recovery program
• Evaluation of an overdose-prevention program, including prescribing of naloxone, for homeless adults who use opioids
• An educational intervention on opioid overdose and naloxone distribution to primary care providers at a Veterans Administration clinic

For the special issue, JAN's regular columns turn their focus to the opioid crisis. The columnists discuss the prevalent "syndemics" of OUD interacting with other conditions, specifically HIV infection and suicide; the importance of medication-assisted treatment as part of the overall approach to treatment for OUD; efforts to overcome barriers to accessing care for OUD, particularly the stigma attached to this condition; and the role of the behavioral resource nurse in helping individuals dealing with medical conditions as well as substance use withdrawal.

In another Guest Editorial, Dr. Snow shares a set of clinical "pearls" to improve outcomes for the patient using opioids. Her tips include assessing risk factors for OUD, managing the psychiatric disorders that often accompany OUD, educating patients and families about the effectiveness of medication-assisted treatment, and offering ongoing support and encouragement to promote safety. Dr. Snow concludes, "We each bear a responsibility to take action to address opioid problems wherever we work, wherever we have influence."

The Editors hope their special issue will provide nurses and other health professionals with knowledge from several sources to inform their evidence-based practice in caring for individuals affected by the opioid crisis. Dr Snow adds: "I encourage nurses and advanced practice nurses to seek certification in addictions nursing as a certified addiction registered nurse [CARN] or certified addiction registered nurse-advanced practice [CARN-AP]."