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Full Sentence Outline

Erica K. Fernandez

Argosy University

Introduction

For clinicians, the hardest challenge is perhaps knowing the right way to handle patients who require pain medication, yet they have a history of addiction to drugs. When speaking about pain medication, opioids are among the first class of drugs to come to mind. There is also a clash that exists between prescribing opioid medication to patients with a history of heroin abuse. Most doctors, fearing the legal ramifications of their actions, often shy away from overprescribing pain medication to patients with a history of drug abuse. There are numerous misconceptions surrounding this topic, such as patients with chronic pain symptoms encountering physicians who do not have enough experience to handle their unique needs. Important to note is that, the main issue of concern is knowing the right way to treat a patient with a history of drug abuse without causing abstinent patients to relapse, or to administer low dosages of pain medication which may lead to the patients being discharged before the right time for their therapy has elapsed, or even designing the proper care interventions that will ensure patients do not relapse.

Topic Sentences for the Supporting Points

There exists no perfect formula for calculating the right amount of opioid doses to administer for pain medication therapies. There are no studies that deeply delve into the issue of how patients with a history of substance abuse should be handled when it comes to administering pain medication to them. For the patients already using opioids illegally, there is a serious challenge during pain management should a time come when they require such interventions (Michna, 2004). With the current legal system, physicians may face legal ramifications for an overdosage of pain medication, meaning they are almost always afraid to make prescriptions.

In the medical world also, there exists a complicated relationship between pain management and patients with addiction problems. Physicians may discharge patients early from pain management programs, meaning the patients encounter problems both in regard to pain and also in regard to their drug abuse problem (Martell, 2007). More so, improper communication has made physicians shy away from taking on patients with drug abuse problems, especially since opioids are the basic components required for pain management, and administering such medication exposes the patients to a high risk of a relapse during or after the pain management therapy.

Lastly, the bureaucracies associated with pain management for patients with drug abuse problems make it difficult for healthcare settings to properly do their work. Notably, physicians lack the proper support from their healthcare facilities to address pain management for patients who have a history of drug abuse (Gourlay, 2005). The lack of acute management teams in most facilities also means that for a healthcare facility to take on patients struggling with drug use, there needs to be written procedures and policies, which are mostly not properly adhered to.

Counter Arguments

One of the main problems encountered by physicians is the determination of the right amount of pain medication to prescribe to a patient struggling with drug use, or on who was a drug user in the past. A counter argument for this is the fact that, doctors can ascertain the amount of pain being experienced by the patient, and then tailoring their dosage prescriptions to much the level of pain. This is however difficult to do since it is not possible to accurately determine how much pain the patient is in.

The pain medication given to patients needs to be regulated. Access to more pain medication drugs may lead to a false sense of pain in the patients. Knowing the pain medication is at their disposal, patients may take medication for pain that is not serious enough to warrant medication (Thorn, 2017).

Finally, pain medication should be administered through a third party, and not directly to the patient. This may work to reduce the possibility of a relapse in the patients. Therefore, administration of pain medication, especially opioids, should be structured in such a way that patients have limited direct access to the medication (Chou, 2009). The medication is only availed to the patients at the prescribed times and for the prescribed amount of time.

Conclusion

It is very difficult to properly ascertain the amount of pain that a patient is going through. The limited nature of research into the correlation between pain therapy and patients with a history of drug use also makes it difficult to properly match the level of pain as described by the patient, with the right pain medication dosage. With the current legal system defining the conduct of healthcare practitioners, most physicians are afraid of the legal issues they may face when they are accused of prescribing more opioid pain medication that is supposed to be.

References

Chou, R., Fanciullo, G. J., Fine, P. G., Adler, J. A., Ballantyne, J. C., Davies, P., ... & Gilson, A. M. (2009). Clinical guidelines for the use of chronic opioid therapy for chronic noncancer pain. The Journal of Pain, 10(2), 113-130.

Gourlay, D. L., Heit, H. A., & Almahrezi, A. (2005). Universal precautions in pain medicine: a rational approach to the treatment of chronic pain. Pain Medicine, 6(2), 107-112.

Martell, B. A., O'Connor, P. G., Kerns, R. D., Becker, W. C., Morales, K. H., Kosten, T. R., & Fiellin, D. A. (2007). Systematic review: opioid treatment for chronic back pain: prevalence, efficacy, and association with addiction. Annals of internal medicine, 146(2), 116-127.

Michna, E., Ross, E. L., Hynes, W. L., Nedeljkovic, S. S., Soumekh, S., Janfaza, D., ... & Jamison, R. N. (2004). Predicting aberrant drug behavior in patients treated for chronic pain: the importance of abuse history. Journal of pain and symptom management, 28(3), 250-258.

Thorn, B. E. (2017). Cognitive therapy for chronic pain: a step-by-step guide. Guilford Publications.