Shift in care could reverse the opioid epidemic

As a clinical nurse in Virginia Beach, I see first-hand the impact of our nation’s opioid epidemic. It is stretching hospital resources and handicapping hospital staff across the United States, with many emergency nurses treating life-threatening overdoses every day.

That is why the Emergency Nurses Association (ENA) supported the Comprehensive Addiction and Recovery Act of 2016 (CARA) and the shift it represents in patient care.

{mosads}Instead of relying primarily on punishment to deter opioid abuse, CARA provides additional tools to treat patients struggling with addiction and changes prescribing practices to prevent addiction from ever taking hold.

CARA addresses perhaps the two largest factors driving the overdose epidemic: overprescription of opioids and public access to the opioid antidote naloxone.

Introduced by Sen. Sheldon Whitehouse (D-RI) and Rep. Jim Sensenbrenner (R-WI), CARA had broad bipartisan support, passing in the House by a 407–5 vote and in the Senate on a 92–2 vote.

It was signed into law by President Obama on July 22. The strong bipartisan support is a testament to the national commitment to end this epidemic. The legislation will prompt changes in patient care across the United States, where a patchwork of laws across jurisdictions has led to an inconsistent response to this crisis.

The new law establishes a task force to review and provide recommendations on developing best practices in pain management and establish grant programs to provide for the purchase and distribution of naloxone. It also allows nurse practitioners to prescribe buprenorphine, thereby expanding access to this medication used to treat opioid addiction.

Additionally, CARA will create a public awareness campaign about the links between prescription painkillers and heroin addiction. It will provide funds to carry out opioid abuse response efforts, including education, treatment and recovery efforts, maintaining prescription drug monitoring programs and preventing overdose deaths.

Unfortunately, what CARA will not do is provide an additional $1.1 billion sought by President Obama to increase access to care for people addicted to heroin and other opioids.

Regardless of this disagreement on the appropriate funding level, it is clear both Congress and the administration are focused on reducing the number of opioid and heroin-related fatalities. The CDC says surpassed car accidents last year as the leading cause of injury-related deaths.

Emergency nurses are on the front lines of the epidemic. We care for overdose patients when they arrive and are responsible for discharging them when they leave.

We can intervene to help emergency departments steer clear of using opioids as a go-to response to pain treatment.  We also want to  drive practices toward the recommendations from the Substance Abuse and Mental Health Services Administration, the American Academy of Neurology and others.

At the same time, we can use our access to patients to educate them about lifesaving treatments and medications.

Perhaps the most powerful such medication is naloxone. In use since 1971, it can reverse the respiratory crash of an opioid overdose and prevent death.

The medication can be administered not only by a patient, but also by a family member or friend — but only if they have access to it.

That’s why the ENA just released the Naloxone Education Toolkit, a resource containing comprehensive background on the opioid crisis. It outlines clear steps for establishing successful opioid addiction programs in an emergency department and information about the proper use of naloxone kits.

Our nation’s 190,000 emergency nurses have been working to establish effective opioid addiction treatment programs in hospital emergency departments.

With tools provided by CARA, emergency nurses and other health care providers will continue to work every day not only to help patients who already abuse prescription opioids and heroin, but to prevent more Americans from becoming addicted to these deadly drugs.

The Emergency Nurses Association (ENA) is the premier professional nursing association dedicated to defining the future of emergency nursing through advocacy, education, research, innovation, and leadership. Founded in 1970, ENA has proven to be an indispensable resource to the global emergencynursing community. With more than 42,000 members worldwide, ENA advocates for patient safety, develops industry-leading practice standards and guidelines, and guides emergency healthcare public policy. ENA members have expertise in triage, patient care, disaster preparedness, and all aspects ofemergency care. Additional information is available at www.ena.org.


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

Tags Drug abuse Jim Sensenbrenner Opioid epidemic Sheldon Whitehouse

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