The healthcare industry has been part of the opioid problem - It’s time we’re part of the solution
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Among the numerous recommendations made to President Trump by the Commission on Combating Drug Addiction and the Opioid Crisis was the call for mandated prescriber education initiatives to help ensure more responsible opioid prescription practices. The commission is right in its assessment that the opioid crisis began in our healthcare system.

And while vital efforts and resources have been focused on helping millions of Americans recover from opioid addiction, not nearly enough attention has been paid to correcting the problem at its source. It is time that the healthcare community comes together, recognizes its faults, modernizes opioid-prescribing criteria and develops more effective, evidence-based solutions to pain management practices, to help prevent rather than treat opioid addiction.

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While news from Centers for Disease Control and Prevention shows progress with a decline in opioid prescriptions over the past three years, U.S. prescriptions are still triple the level they were in 1999 and four times what they are in some European countries.

Moreover, recent studies have shown that more than half of all opioid prescriptions are written for adults with mental health disorders and that patients who present to the emergency room with conditions as minor as sprained ankles are being prescribed opioid-based painkillers in quantities ranging from 20 to 60 pills per prescription.

As long as we continue to view opioids as the indiscriminate first rather than the last possible solution to manage pain, we cannot expect to see any change in addiction and overdose statistics. Rather, we must look to the entire healthcare team to work with patients to better understand their conditions, their histories, their lifestyles and their ability to participate in the pain management process. This multimodal pain management strategy offers solutions that minimize  or eliminate the need for opioids through use of non-opioid medications and alternative therapies.

Acute and chronic pain are best treated and managed by a team of healthcare professionals that actively engages patients in the diagnosis and management of their pain for improved well-being, functionality and quality of life. Certified Registered Nurse Anesthetists, who are on the front lines of pain management, are implementing a proven, multimodal pain management strategy which begins before the procedure and continues through discharge using opioid-sparing techniques such as regional anesthesia, peripheral nerve blocks, non-pharmacologic approaches and non-opioid medications. This thorough assessment and treatment of pain, which may include judicious opioid prescribing, can decrease the risk of acute pain transitioning to chronic pain and the development of opioid dependency and abuse.

Using a holistic, patient-centered decision-making model and robust communications method like this enables all healthcare professionals to facilitate collaborative care between patients and their pain management team through comprehensive analysis of the risks and benefits of different pain management techniques. It also encourages patients to play an active role in their healthcare by expressing their own thoughts and concerns to help establish realistic goals for improved well-being and quality of life.

Last December, Congress passed the 21st Century Cures Act, which provides $1 billion for opioid abuse prevention and treatment programs. Earlier in 2016, the Surgeon General called on clinicians to help end the crisis by becoming better educated on safe and effective pain management, by fully screening patients for opioid use disorder, and by raising awareness of opioid abuse as a chronic illness. These are encouraging steps in the right direction, but until the entire healthcare community unites behind an uncompromising determination to reform the way we treat pain, it will never be enough.

We must seize this opportunity, accept our responsibility and serve as innovators in modernizing pain management. We must come together to rethink our prescribing criteria and develop better pain management practices. We must collaborate to develop evidence-based practice guidance and substance-use disorder resources, continuing education for healthcare professionals and communities on acute and chronic pain management alternatives, and advocate for policy activities in collaboration with healthcare and governmental agencies to prevent overpresciption of opioids and to provide better access to treatment.

We cannot wait another day. The time is now for all healthcare professionals to answer the call and be the leaders our country needs to turn the tide of this crisis. The time is now to not allow one more mother, father, daughter or son to become addicted. We have the tools – it’s time we put them to work.

Cheryl Nimmo is president of the American Association of Nurse Anesthetists, which represents more than 50,000 nurse anesthetists. AANA’s official position statement, A Holistic Approach to Pain Management: Integrated, Multimodal, and Interdisciplinary Treatment, was published in July 2016.


The views expressed by this author are their own and are not the views of The Hill.