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Introduction
Chronic pain can be defined as continual pain patients experience for an extended period of time, and it can impact the quality of life of the affected persons. However, opioid medication prescribed to treat long-term pain is highly addictive and can lead to dependency, drug misuse, and overdoses. This assignment aims to describe the clinical problem of overprescribing opioids to patients in a study comparing their use to acupuncture in adults aged 40 to 60 years of age suffering from chronic pain.
Problem Description
Opioid misuse in pain management and prescribed medication addiction is a significant problem in modern-day healthcare. Although they are regularly prescribed for individuals with chronic pain, opioids are an addictive substance and can have an adverse effect on ones health and well-being if not used correctly and in appropriate doses. Furthermore, there is a substantial risk of the patients developing tolerance and requiring increasingly large amounts of the drug to manage the pain. Therefore, a randomized controlled trial prescribing opioid medication for a group of adults suffering from long-term pain should consider the adverse effects it may have and the risk of developing dependence.
State the PICOT Question
The PICOT question for this assignment is as follows: In adults from 40 to 60 years of age suffering from chronic pain, how does the use of acupuncture (Complementary Alternative Medicine) compare to the use of opioid narcotics over one year? The question focuses on treating persistent pain and comparing two different interventions: the utilization of opioid pain management medication and acupuncture as alternative medicine.
Importance to Nursing Practice
Drug misuse in patients with chronic pain is one of the most significant problems in modern nursing practice. According to Ling (2017), opioid analgesics are the most prescribed pain management treatment in the United States, with 80% of all manufactured painkillers being consumed in the country. These narcotics can have a detrimental effect on the health and overall well-being of the individuals using them.
Prescribed drug use is often characterized by increasing tolerance, abstinence syndrome, and hyperalgesia (Ling, 2017). Furthermore, the development of both physical and psychological dependence can occur after only several weeks of use (Ling, 2017). In addition, patients may be unwilling to admit to the formed addiction to pain medication due to the existing stigma surrounding drug use, leading them to seek illicit substances to supplement prescribed opioids (Gorfinkel et al., 2018). Overall, there is a need for effective alternative treatments for persons diagnosed with chronic pain.
Chosen Intervention
The selected intervention is a randomized controlled trial involving two groups of patients prescribed two different treatments: analgesics and acupuncture as complementary alternative medicine. The study design will help compare the effect of the treatments on adults 40 to 60 years of age suffering from chronic pain. The research will take 12 months to complete, with several evaluations to assess the individuals well-being and pain intensity throughout the trial.
Impact on Outcomes
The patient-relevant consequence of the intervention is the alleviation of long-term pain in suffering adults. According to Ling (2017, p. 74), the therapeutic benefit of opioids for chronic pain is limited, while the benefit/risk ratio decreases with prolonged use as side effects increase. In contrast, acupuncture can lead to a significant pain reduction without significant side-effects (Urits et al., 2020). Moreover, acupuncture can have a persistent effect on the patients, relieving pain up to 12 months after the end of the course (MacPherson et al., 2016). Overall, it is expected that acupuncture will be more effective for pain management than analgesics.
Barriers
Two barriers to the implementation of the discussed intervention can be identified. The first barrier is the lack of clarity on the implementation guidelines regarding the prescription of opioids. Adults suffering from chronic pain can have varying degrees of intensity, leading to the patients being prescribed varying doses and those receiving higher quantities experiencing severe side-effects. This barrier can also result in participants leaving the trial before its conclusion. The second barrier is the ethical standard of beneficence to the participants. As the study includes prescribing addictive narcotics with severe side-effects, the intervention may be considered unethical and not receive approval.
Action One to Handle Barrier
The first barrier can be addressed by recruiting adults with no history of drug abuse. Individuals who previously misused narcotics will have a higher tolerance for opioids, requiring larger doses from the beginning of the trial. All prospective participants will be evaluated for pain intensity, and adults with similar pain levels will be selected for the intervention to ensure all patients will receive similar doses to ensure clear results.
Action Two to Handle Barrier
The second barrier will be addressed by obtaining informed consent forms from all participants. The adults taking part in the study will be explained the primary purpose and objectives of the research and advised one of two different treatments will be randomly assigned to them. The partakers will be provided with an opportunity to leave the trial if they do not feel comfortable being assigned to the group taking opioids or receiving acupuncture. The patients will also be offered the results of the study after it is concluded.
Exclusion and Inclusion Criteria
The trial can produce varying results, including side-effects, tolerance development, increased doses of opioids, and the failure to relieve pain in individuals. The inclusion criteria to be employed in the analysis of the evidence are the alleviation of pain in the participants and the occurrence of any side-effects in individuals subjected to analgesics and acupuncture. The absence of pain relief is also an inclusion criterion. The evidence will be excluded if the patients left the trial before its conclusion and if they were found to be using additional pain medication.
Databases
Two databases were employed to locate relevant research studies pertaining to the topic of opioid and acupuncture use for the treatment of chronic pain and medication misuse in patients with long-term pain. The first database, Science Direct, offers numerous peer-reviewed articles and book chapters on a wide range of subjects, including nursing. The second database employed for the purposes of this assignment was PubMed Central.
The databank fosters a collection of articles primarily on medical topics. Both the websites yielded a substantial number of articles for this paper. The keywords used for the search included the following: chronic pain, opioid, acupuncture, prescribed opioid addiction, and opioid misuse. Overall, the literature for the assignment was quickly located with various combinations of the keywords producing a variety of appropriate research articles.
Conclusion
In summary, chronic pain has an adverse impact on the affected individuals well-being and quality of life. Although opioid analgesics are routinely prescribed for the condition, they are not an effective treatment method, are highly addictive, and can lead to serious side effects. In contrast, acupuncture is considered to be an efficient procedure with no side-effects. The proposed will compare the two treatments and discuss the clinical problem of overprescribing opioids for chronic pain patients.
References
Gorfinkel, L., Voon, P., Wood, E., & Klimas, J. (2018). Diagnosing opioid addiction in people with chronic pain. BMJ, 362, 3949. Web.
Ling, W. (2017). Prescription opioid addiction and chronic pain: More than a feeling. Drug and Alcohol Dependence, 173, 7374. Web.
MacPherson, H., Vertosick, E., Foster, N., Lewith, G., Linde, K., Sherman, K., Witt, C., & Vickers, A. (2016). The persistence of the effects of acupuncture after a course of treatment: A meta-analysis of patients with chronic pain. Pain, 158(5), 784793.
Urits, I., Schwartz, R. H., Orhurhu, V., Maganty, N. V., Reilly, B. T., Patel, P. M., Wie, C., Kaye, A. D., Mancuso, K. F., Kaye, A. J., & Viswanath, O. (2020). A comprehensive review of alternative therapies for the management of chronic pain patients: Acupuncture, tai chi, osteopathic manipulative medicine, and chiropractic care. Advances in Therapy, 114.
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