Welcome to Scribd, the world's digital library. Read, publish, and share books and documents. See more
Standard view
Full view
of .
Look up keyword
Like this
0 of .
Results for:
No results containing your search query
P. 1
Opoid Abuse and Addiction in the Emergency Room

Opoid Abuse and Addiction in the Emergency Room

Ratings: (0)|Views: 33|Likes:
An essay for the 2012 Undergraduate Awards (International Programme) Competition by James Liu. Originally submitted for Treating patients at Other, with lecturer Dominic Vachon in the category of Medical Sciences
An essay for the 2012 Undergraduate Awards (International Programme) Competition by James Liu. Originally submitted for Treating patients at Other, with lecturer Dominic Vachon in the category of Medical Sciences

More info:

Published by: Undergraduate Awards on Aug 31, 2012
Copyright:Attribution Non-commercial


Read on Scribd mobile: iPhone, iPad and Android.
See more
See less


James Liu11/21/11SCPP 30401
Prior to my class I spent my summer volunteering and working in the emergencyroom at my local hospital. From this experience I saw both good and bad in howAmerican health organizations are run. One incident in particular dealing with opoidabuse and addiction peaked my interest. During my time in the Medical Skills Counselingclass Professor Vachon introduced new concepts about the important of patient doctor interactions and trust, empathy, and connections that are built. I reflected back on my pastexperience in the emergency room and I was conflicted between dealing with opoid patient abuse and patient trust and interaction. For my final paper I wanted to further explore the opoid abuse and how it is being handled in our modern medical system. Inone part I explore the definitions of abuse and addiction and how these can be identified.Then I highlight methods of appropriate treatment and things to keep in mind whenundergoing treatment. And finally I address my own perspectives and how both my personal and academic experiences tie into the issue.
Opioid Abuse and Addiction in the Emergency Room
Opioids are psychoactive chemicals that long have been used for their therapeutic benefits. Biologically they target the opioid receptors in the central and peripheralnervous system providing both a psychological and analgesic effect on the body. Theseanalgesic effects include decreased perception and increased tolerance to pain. Therefore,in modern medicine opioids are commonly known as painkillers. They are prescribed inclinical settings for acute and chronic pain under more familiar names like morphine,methadone, oxycodone, and codeine (McCaffrey et al.)However, opioids also provide psychological side effects along with their analgesic properties. These side effects produce a change in mood, decreased anxiety,drowsiness, and a sense of tranquility. Likewise, many individuals note that along withthese effects they have a, “feeling of detachment from the responsibilities of the world
(Hansen.)” For these reasons prescription strength opioids are highly abused and soughtafter drugs. They have the second highest street value to cocaine and the DrugEnforcement Agency estimate that a third of the total illegal drug trafficking is for opioids (McCaffrey et al.) But, despite the abuse of these drugs by individuals they arewidely used as an acceptable method for treating acute and chronic pain in the medical profession. In places like the emergency room, where patients suffer from severeconditions, opioids hold a necessary and vital function to improving medical care andtreatment. Nonetheless, when the patient comes into the clinic seeking to obtain opioidsfor recreational use problems arise.In this paper I will focus primarily on the exploitation of opioids by patients in themedical profession and more specifically the emergency room. In the first part I willdefine the term “drug seeking” patient and identify the different levels of misuse. Then Iwill discuss how to interact and communicate with patients who are abusing or areaddicted opioids. I will focus on connecting with these patients and helping them come toterms with their addiction or abuse. And finally, I will explore my own perspective of opioid abuse and their role in the medical profession.
1. Identification and Definition
There are many forms of opioid misuse in the medical profession and bothdoctors and patients are guilty. In some situations the doctors poorly monitors the paintreatment and creates an abuser or addict. But, for the sake of this paper we will focus onthe more common scenario of the patient misusing these drugs. These patients arecommonly referred to as “drug seekers.”
The medical profession poorly defines the term “drug seeking”. In the most literaldefinition in relation to opioids it is “ patient behavior designed to obtain analgesics for  pain relief (Goldman).” This definition doesn’t seem to hold any negative connotations, but in reality the term has many inferred meanings. As Goldman defines it, “[drugseeking is an] individual who knowingly break the law by seeking and obtainingcontrolled drugs in order to sell them on the street.” He further illustrates that the drugsare obtained for 3 reason; “1 those who have chemical dependency, 2 those who seek drugs to sell on the street, and 3 those who are hired by drug dealers to obtain prescriptions they can sell (Goldman).” Basically, Goldman brings to light the image of a patient who comes into the medical office with no motive other than to fool andmanipulative the doctor or nurse into obtaining drugs. They have a chemical need for thedrug and will pursue any means necessary to fulfill their addiction.In one study done nurses throughout all medical professions were surveyed abouttheir thoughts on “drug seeking” patients. These nurses noted several repeated behaviorswhich include: “asking for pain med then returning to sleep,” “dramatic response to painwhen someone in room but appears comfortable when not seen,” and “demanding themedication or becomes upset or angry when different or lower dose of medications usedfirst (McCaffrey et al.)” Especially in the emergency room the emergency nurses notethat drug seeking patients (in percent who agree), “ go to different emergencydepartments to get opioids (85.7%), tells the nurse where to give the drug and how fast(57.1%), tells inconsistent stories about pain or medical history (74.3%), and asks for arefill because the prescription is lost or stolen (68.6%) (McCaffrey et al.)” These

You're Reading a Free Preview

/*********** DO NOT ALTER ANYTHING BELOW THIS LINE ! ************/ var s_code=s.t();if(s_code)document.write(s_code)//-->