Pain Management Policy
For many people, medicine is the only pills the doctor prescribes. However, according to Turk (2002), about 20% of people in the United States abuse prescription drugs. They use prescription drugs for uses not stated by the doctor. This is what is referred to prescription drug abuse. The quite serious problem has become. When someone abuses prescription drugs for a while, they may get addicted. Someone may develop an addiction to narcotic painkillers, sedatives and tranquilizers as well as stimulants. Experts have been trying to determine why more and more people in the United States are abusing prescription drugs (Turk, 2002).
As Hainline (2005) confirmed, one of the reasons that have been cited for the widespread abuse of prescription drugs has been the fact that these drugs are quite readily available. There has been an increase in the volume of drugs prescribed to patients. The analysts say, the other reason why prescription drugs are abused is that recently drugs have also been available online. This means that even young people are able to order drugs from an online store without a prescription from qualified medical practitioners (Hainline, 2005).
When one abuses prescription drugs for pain, he or she is taking a drug that was no prescribed for him. The prescription drugs may have been described for the individual, but he or she decides to take them for reasons other than those in the prescription. The abuse of drugs, even those that are prescribed, can result in serious health complications other than developing an addiction to those same drugs.
Weaver & Schnoll (2002) and Cook, et. al. (2004), established that the effects of prescription drugs for pain abuse can be either short term or long term. If a person uses depressants for the central nervous system or opioids over a long period of time, he or she is likely to develop a physical dependence on those drugs or an addiction. The opioids usually have severe side effects such as feelings of drowsiness; the person may also feel constipated or may have problems with normal breathing. Depressants that affect the central nervous system usually affect even the brain of the individual who takes them. If the patient combines the depressants with other forms of medication that cause drowsiness or if the person takes a lot of alcohol, the heart and the respiratory system is likely to be affected. If these drugs are taken for long time, they would likely cause an anxiety, feelings of paranoia, irregular heartbeats and sometimes even result in seizures (Weaver & Schnoll, 2002)
The history of prescription drug abuse in the US is very long. In 2007, about twenty-seven thousand people were reported to have abused prescription drugs. In the same year, it was recorded that one drug abuse related death occurred every nineteen minutes. The abuse of prescription drugs is one of the quickest growing problems in the USA. This has been associated with the continued use of a prescription drug known as opioid analgesics (Cook, et. al., 2004).
Once the abuse of prescription drugs has become an addiction, it becomes a chronic medical problem just like addiction to other drugs. It has been found to be growing at an alarming rate, as well. The worrying issue about the abuse of prescription drugs is that teenagers are the most affected. Statistics shows that more and more young people in the US are abusing prescription drugs, especially those that are prescribed for pain. As a result, the governments have the duty of coming up with strategies that ensure that young people are protected from this menace, and that parents are sensitized to ensure that drugs are not abused in their homes.
Research has shown the reason why so many people, especially teenagers abuse prescription drugs mostly because it is so readily available. In many homes in America and even across the globe, left over medicine is not properly kept. Most of the medicine that is left after medication in many homes is left lying in cabinets. The owners of the home or the children are likely to take the medicine that is left over and risk putting themselves in a lot of danger. The abuse of prescription drugs is normally made worse if the person was already abusing other substances. There are parents, who when they get sick tend to medicine that was prescribed for their children. There are cases when parents give their children medicine that has been prescribed for an adult. This happens as a result of the assumption that drugs, as long as they have been prescribed by a doctor, are safe to be used by anyone. This is not true, because drugs are prescribed by a physician only after thorough medical examinations have been carried out. Therefore, these prescription drugs can be extremely dangerous if it is taken in a way that was not specified by the doctor (Lyman, 2010).
Once, someone has been identified as the one who is abusing prescription drugs, the treatment should be based on science. This treatment should be comprehensive and should include anti-addiction formulae. Anti-addiction medication includes Suboxone and Vivitrol, which have been found to be effective in treating patients who are suffering from addiction to prescription drugs. The population should also be sensitized, so that drugs that are left over after medication is properly disposed of and are not left lying around in places where they could be used by other people, especially young ones.
There are those individuals who abuse prescribed drugs thinking that they are safer when compared with illicit drugs. They assume that just because these drugs are prescribed by a qualified doctor and dispensed by a certified pharmacist, they are not harmful to humans. The government, therefore, needs to give priority to reducing the effects of prescription drug abuse, which will help build communities, which are strong and lead healthy better lives.
There are strategies that the government has put in place to deal with the problem of prescription drug abuse. The first strategy that the government intends to use is that of prescription data. This data will help authorities to use insurance restrictions, so that people in the USA do not go "doctor shopping" or use opioids inappropriately. There should be drug monitoring programs in place that ensure that people do not get prescriptions for the same condition from multiple providers. The history of patients should be readily available to authorities through this database to avoid cases where someone takes more medicine than is actually required.
In order to prevent the use of opioids, health insurance providers, whether public or private, should limit the amount of reimbursement they give when a client obtains opioids from hospitals or pharmacists. This will lessen the amount of drugs that people take, because they will not obtain them readily. The same restriction should apply to public insurance providers because the poor people who receive Medicaid are more prone to get addicted to prescription drugs that lessen pain. Insurance providers can use the data available to them to identify those drugs that are mostly abused by patients and also limit the reimbursement for these medications in order to prevent prescription drug abuse.
The second strategy that can be used in dealing with the abuse of prescription drugs in the population is a usage of better legislation. There are laws that already exist concerning the use and abuse of prescription drugs, which are not being followed to the letter at the moment. More needs to be done to ensure that these laws and regulations are actually implemented and enforced. Most of the states in the US already have laws that prohibit doctor shopping, which are, unfortunately, not properly enforced. There are those states, which are very strict with the implementation of laws condemning abuse of prescription drugs, while other states are not so committed to the eradication of prescription drug abuse.
As much as there are laws that prohibit doctor shopping in all states, some states lack laws that regulate the availability of clinics that are for profit. These for- profit clinics usually distribute prescription drugs, which are under minimal control, if there is any supervision. As much as these clinics are regulated to a given degree, they sometimes require physical examination to ensure that they are not simply distributing pills in a way that may affect the population. Moreover, when these drugs are distributed into the community, they end up in the wrong hands and are mostly abused. As such, more control needs to be adopted by states to ensure that fraudsters who are distributing prescription drugs without much care are not allowed to operate within the United States.
The third strategy can be used to reduce the spread of prescription drug abuse by authorities. It is through improved health care services. This will mean that opioids are not prescribed unless they are truly needed to cure a particular medical condition. While there are those patients who suffer from chronic pain as a result of a medical condition, and require these opioids, there are those people who could do without these prescribed drugs taking them on a daily basis. A lot of education is, therefore, needed so that those who prescribe these medicines know the danger they expose patients to when they prescribe to them many painkillers.
Due to lack of awareness, prescribers sometimes recommend opioids as a quick solution to the problem of pain when they treat such patients. When they give them many opioid, they expect the patients to get well. Unfortunately, sometimes these medications result only in addiction and physical reliance by the patients. As the matter of fact, after using opioids for a long time, these patients rarely report any meaningful clinical change in their conditions.
Managing pain without using Drugs
This essay will look at way through which the program can encourage patients who are suffering from chronic pain to live without using drugs. One method is through Acupressure and Acupuncture which are two techniques that are continually becoming very popular with patients who have to deal with chronic pain. Research has proven that when patients who were previously suffering from chronic pain are put through Acupressure and Acupuncture they reported less pain. The program can make use of of these two procedures in managing the pain of patients. The process triggers particular parts of the body relieving the patient of pain.
The other method that the program will use in relieving patients of pain without using drugs is through the use of exercise. Exercise has been known to make an individual more flexible and promotes weight loss. The other benefits of excise include joint stress, strain on muscles and uplifting the range of motion of patients. Through exercise, the patient will be able to release endorphine which are effective in blocking pain signals and preventing them from getting to the brain.
The other method of pain management that the program will adopt is Biofeedback. Biofeedback is especially effective for people suffering fro acute pain particularly headaches and backpains. The process involves placing of electrodes on parts of the body which are able to monitor tension in the muscles, the rate of respiration and the patient’s heart rate. The feedback is then used by the therapist to relax the patient accordingly. The patient is then taught how to produce the calming effect on his own.
Patients will also be able to manage their pain through herbal remedies and nutrition. When someone is suffering from chronic pain, a poor diet is likely to make the pain worse. This is because lack of the necessary nutrients causes inflammation, which then leads to chronic pain. They will be encouraged, therefore, to take more Omega-3 fatty acids and also to eat more leafy vegetables. Patients who wish to reduce pain will also be taught how the consumption of whole grains are necessary in the reduction of inflammation that occurs in the body. Pain can also be manipulated through Massage and Chiropracty, which help in relaxing muscles that are tensed therefore increasing the circulation of blood. This will help relieve patients of pain. Due to the fact that, chronic pain can sometimes be caused by emotional or mental stress, psychotherapy is a good way to also manage pain. The issues that cause stress should therefore be addressed to reduced theses stresses.
There is medical evidence showing that when opioids are prescribed frequently and in high dosages, there can be risks, which may cause serious health complications. This awareness should be created particularly in hospital emergency rooms where people who have abused prescription drugs are normally rushed. In addition, people with painful emergencies normally rush to emergency rooms of hospitals hoping to find medications that will relieve them of the pain they may be experiencing. There should be laws, which hold medical who prescribe many opioids to patients accountable for their actions.
It will be important that health workers adopt a public health approach to the issue of prescription drug abuse or overdose. Tertiary and secondary prevention measures should be adopted to ensure that the harm caused by prescription drug overdose is minimized. Opioid antidotes should be distributed to more people in order to reduce the harm that is caused when someone over uses prescription drugs for pain. This means that in the event of an emergency, the patient can be help without necessarily rushing to the emergency room in a hospital. Health professionals should also be readily available to deal with emergencies when they occur so that people do not die simply because they do not have access to medical care. The government should also support programs that help people recover from substance abuse. More effort should be made to ensure that barriers are removed from these programs, so that these programs are removed from methadone kind of clinics and are instead made to be office-based. When they are turned into office care kind of clinics, they will use buprenorphine instead of methadone. Office- based care is also more appropriate, because the patients who seek help from them are less stigmatized and they are more accessible, especially for the patients coming from upcountry.
An example of a state in the US that has done a lot concerning the abuse of prescribed drugs is Washington. The state of Washington has been very aggressive in its approach to public healthcare and the usage of opioids. They have established guidelines, which emphasize a system, called the yellow flag. The yellow flag guideline requires that not more than 120mg of morphine is served to a patient in one day. These guidelines, which were introduced early in 2007, are web-based tools.
The program also contains two hours worth of training, which educates the public on the best prescription practices. It requires that there must be an agreement between the prescriber and the patient. The program also includes drug screening, which is judicious and random. However, even after the introduction of these new guidelines, a large number of the population within state continued suffering from the condition, there was still a considerable difference in the way the prescription drugs were administered. This is because prescribers cited the lack of the necessary tools that are needed to implement fully the program. A survey done has revealed that there are still gaps that need to be addressed if the program is to be properly implemented. Many of those health practitioners interviewed admitted that they were not conducting the urine test as often as they were required to. Some of them, were not even conducting the urine tests at all. This was the major reason why other sources of information, such as the questionnaires, which were given to patients to fill-in, were introduced instead. These, the authorities realized, provided more accurate information about administration of drugs.
There should be specific methods that are developed to offer training on pain proficiency to prescribe for both, the private and the public sector. These primary care prescribers can become consultants or mentors to their colleagues, especially in the rural areas. The universities in the various states can also be involved in the research for the reduction of the effect of prescription drug abuse. The legislation by the state of Washington that repealed the rules regulating prescription of drugs, which was largely permissive and replaced it with new rules that were stringent, is one that should be adopted by other states in America (Strassels, et. al., 2006).
There have been cases where the reduction of harms caused by prescription drug abuse has been politicized. This has made it very difficult for policy makers to come up with proper programs that will ensure that prescription drugs are not abused. Statistics show that not less than forty percents of Americans use hard drugs and prescription drugs for reasons that are not medical. While America has declined the use of cocaine, marijuana use continues to be on the rise. However, there has been an increase in the number of deaths that are associated with abuse of prescription drugs. Interventions on the deaths that occur as a result of prescription drug abuse are normally divided into five categories including domestic law enforcement, prevention, treatment, and international reduction efforts. This categorization has been faulted for being traditional and ineffective in reducing the harm that prescription drug abuse causes to many families in America. This is because the traditional approach fails to recognize the fact that law enforcement is not synonymous with the control of supply. This is because law enforcers are required to do more than just reduce the supply of drugs in the country (Keefe, et. al., 2004).
The program will be able to prevent prescription drug abuse right from where it begins. Many Americans who need a treatment will be able to access appropriate treatments. Public safety will also have to be ensured, so that abusers of prescription drugs are attended adequately. The approach to this program needs to be one, which is balanced and is able to bring all sectors of the society together. When all members of the American community are united in efforts to reduce the effects of prescription drug abuse, public health and safety will be improved. The government should be able to fund most of these programs that are legitimate,and are trying to help the American youth who are currently addicted to prescription drugs (Miller, Lestina & Smith, 2001).
The program will also include education of the public in an effort to reduce the effects of prescription drug abuse. The University Academic Integrity Policies should incorporate awareness of the consequences of medication without prescription into its systems. The education concerning drug overdose should also be introduced both at elementary and secondary levels of education, so that students are made aware of the dangers of using medication without a prescription (The Joint Commission, 2002).
The program managers should also work closely with organizations that are non-profit, the federal government as well as the state government in order to be fully implemented. Those in charge of implementing the program should also take part in public education initiatives that will change the norms and teach the community about how they should use prescribed medication appropriately, store them safely and dispose them responsibly. The program should be able to quantify the rates of diversion, the amount of drugs being prescribed and those that are being abused. This data will help policy makers understand the misuse of opioid in the community by those suffering from chronic pain, so that legitimate pain care is provided to these patients. Multiple sectors of the communities must, therefore, be brought together in the fight against painkiller abuse if the program succeeds.
Schadelbauer, Katz & Chapman (2001) reiterate that the other sectors that must also be incorporated into the program are distributors of drugs and pharmaceutical companies. The distributors need to conduct extensive research in order to develop treatments that are not opioid-based formulations, which deter the abuse of opioids through dispensing mechanisms that are more advanced. In the same breath, private enterprises should also conduct research in order to come up with advanced technology that will assist law enforcement agencies to track the suppliers of prescription medication in the country. Such advanced technological developments include identification through radio frequency and data sharing systems that monitor prescription programs. The program should also have a built system of disposing off prescription drugs that have not been used or those that are out dated. Such drugs, if left lying around, may be taken by unsuspecting individuals and this may harm their health. Another important technological advancement that can be used is the infiltration technology, which is able to remove any traces of medication that is in wastewater. Healthcare systems all over the United States should insist on the use of the identity verification technology. This technology will identify patients in order to discourage those who may choose to go doctor shopping (Schadelbauer, et. al., 2001).
Finally, in order for this program to be a success, it will be necessary to involve law enforcers in the program. Investigators should, therefore, be dedicated to the work of tracking down companies that may not be following the rules and regulations that have been put in place to reduce prescription drug abuse. Medical experts should also be involved in the war against prescription drug abuse (Hayden, et. al., 2005). These medical experts will be able to identify prescribers who intentionally divert while prescribing medications to patients. They will also be able to give appropriate medication for recovery to patients who have already suffered from misuse of prescription drugs. The medical schools in America should also be included in a program that tries to reduce the effects of prescription drug abuse. General Precautions should be included in the approach to prescription of medicine and in the medical school curricula. Racial and ethnic minorities should also be recruited to medical schools, so that future health practitioners would be in a better position to provide care for prescription drug abusers in a way that is appropriate for various genders, cultures and languages.
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