Health practitioners face legal, ethical as well as pragmatic issues when handling patients with addictions. It is quite challenging to distinguish between physical dependence, true addiction, and pseudoaddiction (Cheatle et al., 2014). Regardless of these factors, clinicians are expected to meet the needs of the patients effectively. Employing opioids in the treatment of chronic pain is on the rise even though the effects that come with long-term use are not well established. As the abuse of opioids continues to rise, healthcare givers ought to be more vigilant when prescribing opioid therapy.

The article summarizes how patients under addiction should be treated by creating an avenue for broadening the guidelines in the area of specialization (St. Marie, 2014). Opioids are used as the final option in the treatment of chronic pain. They are mostly prescribed to patients with chronic pain such as cancer patients and other terminal diseases. However, ever under prescription, these drugs are still misused. Some of the causes for abuse include self-medication, diversion of use to profit and use out of addiction.

The study used qualitative design which made it possible to relate chronic pain with substance use disorder. The narrative inquiry provides a steady story from the viewpoint of the contributors enabling investigators to carry out more analysis (St. Marie, 2014). The article reveals that participants admitted that they used deceptive tactics to acquire opioids whenever their cravings got beyond control. Also, the participants had issues with healthcare providers since they had an inadequate understanding of the pain they were going through. The participants also said that they abused drugs since clinicians gave them poor treatment. Additionally, they also narrated what went well with them and provided recommendations on the improvements that can be made to treat pain effectively. Pain medication and existing substance disorders call for specialized care since they mutually potentiate and activate each other. Using opioids in the treatment of pain has promoted substance abuse disorders and has also caused relapse in patients recovering from substance abuse disorders. Pain in an individual can worsen more so if it is masked under substance abuse. Anytime that the participants’ use of drugs was beyond their control, they experienced more pain, and whenever the pain got out of control, their cravings worsened.

Although patients have a feeling that healthcare providers do not manage pain as required, the clinicians feel that prescribing opiate drugs will harm them since they are activators of substance abuse disorders (St. Marie, 2014). Physical illnesses including low back pain, headache, and arthritis are common among people recovering from substance abuse disorders due to excessive use and risky behaviors. Persons on chronic opioid treatment opt to conceal their treatment from others since they fear that they will lose control over their prescribed opioid and that they may be stigmatized even though they show positive outcomes. Literature indicates that there are positive outcomes for long-term opioid therapy which are reduced pain, improved quality of life, and better function (Painter, 2017). On the contrary, other studies have also shown adverse effects which include increased morbidity, a decrease in function, recurring hospitalization, prolonged hospital stay, and high healthcare utilization. The risk of death and overdose is also an issue to look into since most deaths caused by opioids involved several types of drugs such as heroin, cocaine, and benzodiazepines. Moreover, individuals with mental disorders are at high risk of overdosing even if the safe prescription of pain medication is administered to them.

There are diverse views about the use of pain medication especially opioids. Nevertheless, a centralized approach is required in the prescription of opioids to patients suffering from chronic pain with genuine medical need while at the same time addressing the substance abuse disorders affecting them. In doing so, it will also be possible to address the issue of misuse and diversion. People recovering from substance abuse disorders would be the best persons to interview in the process of developing a safe and efficient criterion of managing patients in such a situation. Diversion of psychoactive medication is a threat to public health since it is not possible to treat a patient’s pain without dealing with the cause of addiction (Cheatle et al., 2014). At least two UDTs should be conducted annually for patients who have insignificant levels of abuse and four times for those termed to be at high risk of abusing drugs. However, physicians with high levels of expertise may not find it needful to obtain UDT not unless they observe a tangible change in behavior. It is also worth noting that currently there is no standardized UDT used by all clinicians.

The prescription of pain medication particularly opioids has been on the rise over the years and has stirred many health concerns. Even though they are used in the management of chronic pain patients has continuously abused them with psychological stressors being the primary causes of abuse. Health practitioners should prescribe pain medication according to patient’s risk stratification. Stratification of risk and continuous assessment remain to be essential tools in guiding physicians on how to offer to care to their patients.

References

St. Marie, B. (2014). Health care experiences when pain and substance use disorder coexist: “Just because I’m an addict doesn’t mean I don’t have pain.” Pain Medicine, 15(12), 2075-2086.

Cheatle, M., Comer, D., Wunsch, M., Skoufalos, A., & Reddy, Y. (2014). Treating pain in addicted patients: recommendations from an expert panel. Population health            management,   17(2), 79-89.

Painter, S. G. (2017). Opiate crisis and healthcare reform in America: A review for nurses. OJIN: The Online Journal of Issues in Nursing, 22(2).