There is no doubt that prescription medications play a crucial role in modern healthcare. Medications can support patients by managing numerous acute and chronic medical conditions, and can offer beneficial preventative measures for people at risk for illness.
Unfortunately, we also know that medications are never completely free of risk. The opioid epidemic experienced in this country is a well-known example of how we let an important resource get out of control. While opioid stewardship has improved modestly over the last few years, opioid misuse and abuse still remains a significant problem, with 2.1 million people in the U.S. suffering from some form of opioid use disorder.
Responsible opioid prescribing practices are an absolute necessity when looking to mitigate acute complications and long-term opioid effects. Prescribing opioids safely can be challenging, but courses like Safe Opiate Prescribing by Premiere Education can help describe safe opioid practices and identify resources to lean on when more information is needed to keep patients safe.
Generalized Effects of Opioids
It is the responsibility of the prescriber to make sure patients are well informed about the effects opioids can have on their bodies. Both short- and long-term opioid effects need to be appreciated so they understand the potential problems that can develop.
Short-Term Effects of Opioids
Various opioids are used in the management of pain, and with them comes diversity in the intensity and duration of their effects. Opioids can affect the patient’s physiology in a number of ways, and the severity of those effects can depend on factors like dosing, frequency, and previous exposure to such medications.
Minor short-term opioid effects can include symptoms like constipation as certain bodily functions slow down, or nausea for those who are sensitive to gastrointestinal upset.
Opioids also have the potential to cause central nervous system depression, and patients may experience symptoms like drowsiness or alterations in their mental status. Some people experience changes in their balance that impact their ability to ambulate, and opioids can even cause more serious side effects like suppressed respiration and heart rate.
Long-Term Opioid Effects
While the short-term effects of opioid use can certainly be concerning, long-term adverse effects of opioid use tend to be the most problematic. The greatest of these could be the potential for dependency, as ongoing use of opioids to manage chronic pain creates the perfect storm for developing dependency and addiction.
Physical dependence on opioids creates a scenario where, if the person attempts to stop taking the opioid medication, they are almost certain to experience withdrawal. The symptoms of withdrawal can often be quite severe, and drive that person to seek out more opioids—possibly from illicit sources—for relief.
Long-term use of opioids can also impact other body systems over time. Chronic constipation, for example, can turn what was previously an uncomfortable inconvenience into something with concerning implications related to gastrointestinal blockage or perforation. Reduced bone density can put people at risk for injury, and increased immunosuppression may make people susceptible to a host of diseases.
Opioid Knowledge Gaps
An additional complication of opioids is a significant knowledge gap in prescribing practices, and it’s not just limited to healthcare professionals. A lack of basic information is a major problem surrounding opportunities for further research, policy development, and drafting of legislation.
Understanding the conceptual underpinnings of addiction, how that differs from dependence, and an awareness of complicating factors for high-risk populations are essential for responsible opioid prescribing. Addiction and dependence are complex challenges with many layers, and they are critical considerations for implementing effective pain management protocols.
For the opioid epidemic to come to an end, it is important for providers to have a good understanding of Safe Opiate Prescribing. This means making a complete assessment of the need for opioids, and proper treatment planning that is both effective and considerate of addiction, diversion, and misuse.
Prescription Practices for Opioids
To mitigate the risk of short- and long-term opioid effects for patients, healthcare professionals must balance the side effects against the benefits of managing the patient’s pain. This should include an appreciation for the nature of the pain—such as acute versus chronic—as well as any pain medication that’s already being used.
This assessment can be influenced by the setting in which the pain is being managed. For example, pain management in an acute care environment such as a hospital is often different than if the patient is taking the medication at home. In the hospital, pain management using opioids is heavily regulated with strict parameters for administration. There are also adjunctive medications and non-opioid alternatives that are often easily accessible.
Managing pain outside the hospital presents a much greater risk for misuse and abuse because it’s a far less regulated environment. However, in-home use is an unavoidable reality of effective healthcare, and it’s prompted groups like the World Health Organization to develop multi-modal approaches with first-line medication being non-opioid analgesics.
Safe Opioid Prescribing Can Help Reduce Short and Long-term Effects
Safe opioid prescribing policies and practices are absolutely critical for the U.S. getting a handle on the opioid epidemic. Healthcare providers—especially those with prescribing privileges—need to appreciate the value of education for understanding short- and long-term opioid effects, and how to support patients by limiting their risks.
Courses like Safe Opiate Prescribing by Premiere Education offers an overview of safe practices, ways to lessen diversion and misuse, and discussions on prescribing guidelines.created by Mary Ellen Biggerstaff DNP, MPH, FNP, an experienced educator and clinician working with Substance Use Disorder.
