Barbara St. Marie, PhD, ANP, GNP, ACHPN
Presents at Congressional Briefing
December 7, 2017, the Nursing Community Coalition hosted a Congressional Briefing in Washington, DC, on The Opioid Crisis: Nursing Practices That Save Lives and the role of nurses in helping patients with problems related to this issue. The American Society for Pain Management Nursing® (ASPMN®) was one of four nursing organizations asked to provide an invited speaker to present on this issue.
ASPMN® is part of the Nursing Community Coalition, which includes 58 members that are the cross section of education, practice, research and regulation within the nursing profession. Wade Delk represents ASPMN® at this coalition.
The Board of Directors of ASPMN® asked me to present on the Role of Nursing Research in the Midst of the Opioid Epidemic.
I highlighted the following points:
- Nursing science is good for the public.
- The holistic vision of nursing is the foundation for nursing research.
- The turbulence that exists between managing people with pain and managing people with opioid use disorder has created great chaos. But out of chaos comes a shift in paradigm that will result in solutions.
- Patients with pain and opioid use disorder have complications that go beyond pain and opioid use disorder alone. They have more psychiatric disturbances, higher utilization of health care services, lower quality of life and less social support.
Healthcare providers caring for this population lack support of their colleagues or healthcare systems, and there is limited insurance coverage for everything except opioids. I cited the Advanced Practice Nurse study funded by ASPMN® to look at practice when caring for this population.
The results of this study provided policy recommendations:
- A need for insurance coverage for non-opioid and non-medicine modalities for pain
- Provide training and educational resources including guidelines that fit this population with pain and opioid use disorder
- Increasing use of naloxone
- Expanding use of medication-assisted treatment
- Provide mandatory Risk Evaluation and Mitigation Strategies (REMS) education
Patients feel a great deal of stigma and marginalization by the healthcare team when they seek care. Healthcare providers need to understand that patients fear substance use disorder or relapse, and fear losing access to opioids for pain management.
A recent study among patients in the Veterans Administration shows when opioids are discontinued there are high rates of suicidal ideation and suicidal self-directed violence.
We need to gather our resources to provide support for this patient population.
Managing surgical or trauma pain well with opioid sparing or non-opioid interventions can minimize the size of the next wave of opioid dependent people (this is a quote that I used from Jason Sawyer, RN, BSc.N, MN, NP, an ASPMN® Board Member).
Understanding that social factors rank high in importance for overall patient risk for opioid abuse and diversion.
Nurses can modify the trajectory of the opioid crisis by research, clinical care, and education of nurses and the public.
Nurses are well positioned to educate patients and their families and caregivers about the many interventions available today, safe keeping of opioids, and proper disposal of unused medication, access the prescription drug monitoring programs in their own states (this is a quote that I used from Debra J. Drew, MS, ACNS-BC, RN-BC, also an ASPMN® Board Member).
The community of ASPMN® has realized this problem well before it became known to the public and have activated many initiatives:
- Support of and show casing nursing research in this area.
- Publication of articles addressing this area in the Pain Management Nursing journal.
- Provide information through the Position Papers and Core Curriculum.
- Endorsement of a White Paper from the Nurse Practitioner Healthcare Foundation entitled, Managing Chronic Pain with Opioids: A Call for Change, 2017.
- Nursing Science is good for the public and will continue to be so.
I was honored to be able to represent ASPMN® at this important Capitol Hill Briefing. There was standing room only, and it overflowed into the hall. I hope they heard what I said, understand what ASPMN® has done and continues to do, and now have a clearer understanding of what nurses do to save lives.
Barbara St. Marie, PhD, ANP, GNP, ACHPN