From the Guidelines
The opioid epidemic remains a significant public health crisis, and Nurse Practitioners (NPs) play a crucial role in reducing morbidity and mortality associated with Opioid Use Disorder (OUD).
Current State of the Opioid Epidemic
- The opioid-related overdose is the leading cause of unintentional death in North America 1.
- Medications for opioid use disorder (MOUD), such as methadone, buprenorphine, and naltrexone, have been shown to reduce opioid toxicity deaths and mitigate the ongoing public health emergency 1.
Role of Nurse Practitioners in Reducing OUD
- NPs can contribute to reducing morbidity and mortality associated with OUD by providing access to MOUD, educating patients and families about OUD, and promoting evidence-based treatment 1.
- NPs can also play a key role in addressing barriers to MOUD access, such as lack of institutional support, lack of mental health and psychosocial support, and lack of confidence in managing opioid addiction 1.
Strategies to Improve MOUD Access
- Lifting barriers that impede access to MOUD, such as removing caps on the number of patients who can receive buprenorphine, and removing onerous limits on medications for overdose prevention and medication-assisted treatment 1.
- Providing pre- and post-buprenorphine training support and education tools to assist physicians and NPs in their treatment efforts 1.
- Establishing a national Prescription Drug Monitoring Program (PDMP) to reduce the number of patients receiving prescriptions from multiple providers and help ensure that pain medications are not diverted 1.
Evidence-Based Treatment
- Medication-assisted treatment using buprenorphine has an impressive success rate for treating patients with OUD, with an average of an 80% reduction in illicit opioid use, along with significant increases in employment and other indices of recovery 1.
- Naloxone, an opioid antagonist that can reverse a narcotic opioid overdose, should be made widely available, and legal protections should be established to encourage its use 1.
From the Research
Current State of the Opioid Epidemic
- The opioid epidemic has led to a significant increase in drug overdose deaths, with 100,306 cases occurring in the United States over 12 months from 2020 to 2021, a 28.5% increase from the previous year 2.
- Three quarters of these deaths involved opioids, complicating chronic pain management and highlighting the need for effective solutions 2.
- The COVID-19 pandemic has accelerated the increase in overall substance use and interrupted access to treatment, exacerbating the opioid epidemic 3.
Role of Nurse Practitioners in Reducing Morbidity and Mortality
- Nurse practitioners (NPs) can play a crucial role in providing care for individuals with opioid use disorders (OUDs) and mitigating the opioid epidemic 4.
- NPs' prescription of opioids for chronic pain management is not well understood, and their education and training in this area are essential for effective management 2.
- Barriers to NPs' opioid management include limited time, lack of faculty expertise or confidence, and stigma, while facilitators include faculty champions, availability of external educational resources, student interest, and financial incentives 4.
Strategies for NPs to Contribute to Reducing Morbidity and Mortality
- Providing NPs with current guideline-based education regarding opioid prescription and emphasizing patient education can improve their opioid management and reduce associated prescription barriers 2.
- Supplying NPs with systemic support, encouraging interprofessional collaboration, and solving prescriptive authority issues can also enhance their opioid prescription and chronic pain management knowledge 2.
- NPs can treat patients with OUDs, mitigating significant barriers to care reported in light of the opioid epidemic, and graduate NP programs should assure that curricula adequately cover opioid use and related management 4.
- Recent advances in therapeutic options for OUD, such as medication-assisted treatment (MAT) and novel approaches like psychedelics and neuroimmune therapies, offer promise in the fight against the opioid epidemic 5, 3.