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“I’m in Pain!”

  • Theresa Baxter
Chapter

Abstract

In this chapter, we will explore three cases involving patients admitted to the hospital with evidence of opioid use disorder. Each patient’s story is unique; however, they share a serious medical condition that is often fatal if untreated. At the conclusion of the case discussions, learners will understand the social, ethical, and public health context of opioid use disorder and recognize the importance of prevention and treatment of this disorder. Learners will also begin to understand the ethical and social challenges in caring for patients with chronic pain, including people who have sickle cell disease and those on chronic opioid therapy. Finally, learners will identify ways in which physicians and other healthcare practitioners have contributed to the opioid epidemic and how they can help to address it in their communities.

Keywords

Addiction Opioid use disorder Sickle cell disease 

References

  1. 1.
    American Society of Addiction Medicine. Public policy statement: definition of addiction [Internet]. Rockville (MD): ASAM; 2011 Apr 12 [cited 2018 Jul 30]. Available from: https://www.asam.org/resources/definition-of-addiction.
  2. 2.
    Substance Abuse and Mental Health Services Administration. Medication-Assisted Treatment (MAT). Rockville (MD): SAMH. [cited 2018 Jul 30]. Available from: https://www.samhsa.gov/medication-assisted-treatment.
  3. 3.
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.CrossRefGoogle Scholar
  4. 4.
    International Association for the Study of Pain. IASP terminology [Internet]. Washington, D.C.: IASP. [cited 2018 Jul 30]. Available from: http://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1698.
  5. 5.
    Zempsky WT. Treatment of sickle cell pain: fostering trust and justice. J Am Med Assoc. 2009;302:2479–80.CrossRefGoogle Scholar
  6. 6.
    Royal CD, Jonassaint CR, Jonassaint JC, De Castro LM. Living with sickle cell disease: traversing “race” and identity. Ethn Health. 2011;16:389–404.CrossRefGoogle Scholar
  7. 7.
    Wesley KM, Zhao M, Carroll Y, Porter JS. Caregiver perspectives of stigma associated with sickle cell disease in adolescents. J Pediatr Nurs. 2016;31(1):55–63.CrossRefGoogle Scholar
  8. 8.
    Centers for Disease Control and Prevention. Understanding the epidemic. https://www.cdc.gov/drugoverdose/epidemic/index.html. Accessed 30 July 2018.
  9. 9.
    Department of Health and Human Services. What is the opioid epidemic. https://www.hhs.gov/opioids/about-the-epidemic/index.html. Accessed 30 July 2018.
  10. 10.
    Centers for Disease Control and Prevention. Lesson 1: Introduction to epidemiology. https://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section11.html. Accessed 31 July 2018.
  11. 11.
    Krebs EE, Carey TS, Weinberger M. Accuracy of the pain numeric rating scale as a screening test in primary care. J Gen Intern Med. 2007;22(10):1453–8.CrossRefGoogle Scholar
  12. 12.
    Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14:798–804.CrossRefGoogle Scholar
  13. 13.
    Morone NE, Weiner DK. Pain as the 5th vital sign: exposing the vital need for pain education. Clin Ther. 2013;35(11):1728–32.CrossRefGoogle Scholar
  14. 14.
    Baker DW. History of the joint Commission’s pain standards. Lessons for Today’s prescription opioid epidemic. JAMA. 2017;317(11):1117–8.CrossRefGoogle Scholar
  15. 15.
    Centers for Disease Control and Prevention. Opioids for acute pain: what you need to know [Internet]. Atlanta (GA): CDC. [cited 2018 Jul 31]. Available from: https://www.cdc.gov/drugoverdose/pdf/patients/Opioids-for-Acute-Pain-a.pdf.
  16. 16.
    Dumas F. After surgery in Germany, I wanted Vicodin, not herbal tea. The New York Times [Internet]. 2018 Jan 27 [cited 2018 Aug 2]. Available from: https://www.nytimes.com/2018/01/27/opinion/sunday/surgery-germany-vicodin.html.
  17. 17.
    Centers for Disease Control and Prevention. CDC guideline for prescribing opioids for chronic pain [Internet]. Atlanta (GA): CDC. [cited 2018 Jul 31]. Available from: https://www.cdc.gov/drugoverdose/prescribing/guideline.html.
  18. 18.
    Porter J, Jick H. Addiction rare in patients treated with narcotics. N Engl J Med. 1980;302:123.PubMedGoogle Scholar
  19. 19.
    Leung P, Macdonald EM, Dhalla IA, Juurlink DN. A 1980 letter on the risk of opioid addiction. N Engl J Med. 2017;376:2194–5.CrossRefGoogle Scholar
  20. 20.
    Haffajee RL, Mello MM. Drug companies’ liability for the opioid epidemic. N Engl J Med. 2017;377:2301–5.CrossRefGoogle Scholar
  21. 21.
    Centers for Disease Control and Prevention. Vital signs: overdoses of prescription opioid pain relievers --- United States, 1999—2008. MMWR. 2011;60(43):1487–92.Google Scholar
  22. 22.
    Guy GP Jr, Zhang K, Bohm MK, et al. Vital signs: changes in opioid prescribing in the United States, 2006–2015. MMWR Morb Mortal Wkly Rep. 2017;66:697–704.CrossRefGoogle Scholar
  23. 23.
    Centers for Disease Control and Prevention. US prescribing rate maps [Internet]. Atlanta (GA): CDC. [cited Jul 2018]. Available from: https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html.
  24. 24.
    American Society of Addiction Medicine. National practice guideline for the use of medications in the treatment of addiction involving opioid use. Rockville (MD): ASAM; 2015 [cited 2018 Jul 31]. Available from: https://www.asam.org/docs/default-source/practice-support/guidelines-and-consensus-docs/asam-national-practice-guideline-supplement.pdf.
  25. 25.
    Office of the Surgeon General. Facing addiction in America: the surgeon general’s report on alcohol, drugs, and health. Washington, D.C.: U.S. Department of Health & Human Services. [cited 2018 Jul 31]. Available from: https://addiction.surgeongeneral.gov/.
  26. 26.
    U.S. Department of Health & Human Services. Trump administration awards grants to states to combat opioid crisis [Internet]. Washington, D.C.: HHS. https://www.hhs.gov/about/news/2017/04/19/trump-administration-awards-grants-states-combat-opioid-crisis.html. Accessed 31 July 2018.
  27. 27.
    American Society of Addiction Medicine. Public policy statement on the use of naloxone for the prevention of opioid overdose deaths [Internet]. Rockville (MD): ASAM. [cited 2018 Jul 31]. Available from: https://www.asam.org/docs/default-source/public-policy-statements/use-of-naloxone-for-the-prevention-of-opioid-overdose-deaths-final.pdf.
  28. 28.
    Centers for Disease Control and Prevention. Expanding Naloxone use could reduce drug overdose deaths and save lives [Internet]. Atlanta (GA): CDC; 2015 Apr [cited 2018 Jul 31]. https://www.cdc.gov/media/releases/2015/p0424-naloxone.html.
  29. 29.
    Association of State and Territorial Health Officials. 2018 State legislation addressing naloxone. Arlington (VA): Astho; 2018 Apr [cited 2018 Jul 31]. Available from: http://www.astho.org/StatePublicHealth/2018-State-Legislation-Addressing-Naloxone/04-05-18/.
  30. 30.
    New York State Library. Combatting the opioid epidemic: New York libraries save lives [Internet]. Albany: New York State Department of Education; updated 2018 Sep 4 [cited 2018 Aug 2]. Available from: http://www.nysl.nysed.gov/libdev/opioid/index.html.
  31. 31.
    American Society of Addiction Medicine. Summary of the comprehensive addiction and recovery act [Internet]. Rockville (MD): ASAM. [cited 2018 Jul 31]. Available from: https://www.asam.org/advocacy/issues/opioids/summary-of-the-comprehensive-addiction-and-recovery-act.
  32. 32.
    Drug Policy Alliance. 911 good Samaritan: explaining NY’s fatal overdose prevention law [Internet]. New York: Drug Policy Alliance. [cited 2018 Jul 31]. Available from: http://www.drugpolicy.org/sites/default/files/911_Good_Samaritan_Informational_Brief.pdf.
  33. 33.
    Goldensohn R. They shared drugs, someone died: does that make them killers? The New York Times [Internet]. 2018 May 25 [cited 2018 Aug 2]. Available from: https://www.nytimes.com/2018/05/25/us/drug-overdose-prosecution-crime.html.
  34. 34.
    National Alliance for Model State Drug Laws. Prescription drug monitoring program (PMPM/PMP) basics [Internet]. Harrisburg (PA): NAMSDL; 2018 [cited 2018 Aug 1]. Available from: http://namsdl.dynamicwebware.com/News%20Tab/Highlighted%20Issues/PDMP%201-Pager%20(FINAL).pdf.
  35. 35.
    The Pew Charitable Trusts. When are prescribers required to use prescription drug monitoring programs? [Internet]. Philadelphia (PA): Pew Trusts; 2018 Jan 24 [cited 2018 Aug 1]. Available from: http://www.pewtrusts.org/en/research-and-analysis/data-visualizations/2018/when-are-prescribers-required-to-use-prescription-drug-monitoring-programs.
  36. 36.
    U.S. Department of Health & Human Services. Mental health and substance abuse coverage [Internet]. Baltimore (MD): U.S. Centers for Medicare & Medicaid Services. [cited 2018 Aug 1]. Available from: https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/.
  37. 37.
    Bevilacqua L, Goldman D. Genes and addictions. Clin Pharmacol Ther. 2009;85(4):359–61.CrossRefGoogle Scholar
  38. 38.
    Bender MA. Sickle cell disease. In: Adam MP, Ardinger HH, Pagon RA, et al., eds. GeneReviews®. Seattle: University of Washington, Seattle; 1993–2018. [2003 Sep 15; updated 2017 Aug 2017]. Available from: https://www.ncbi.nlm.nih.gov/sites/books/NBK1377/.
  39. 39.
    Brousseau DC, Owens PL, Mosso AL, Panepinto JA, Steiner CA. Acute care utilization and Rehospitalizations for sickle cell disease. JAMA. 2010;303(13):1288–94.CrossRefGoogle Scholar
  40. 40.
    Department of Health and Human Services, National Heart, Lung and Blood Institute. Expert Panel: evidence based management of sickle cell disease. Rockville (MD): National Institute of Health; 2014 [cited 2018 Aug 1]. Available from: https://www.nhlbi.nih.gov/sites/default/files/media/docs/sickle-cell-disease-report%20020816_0.pdf.
  41. 41.
    Porter JS, Wesley KM, Zhao MS, Rupff R, Hankins JS. Pediatric to adult care transition: perspectives of young adults with sickle cell disease. J Pediatr Psychol. 2017;42(9):1016–27.CrossRefGoogle Scholar
  42. 42.
    Kaiser Health News. Two drug epidemics, decades apart: why government’s response to opioid epidemic different than crack crisis [Internet]. San Francisco (CA): Kaiser Family Foundation; 2018 May 7 [cited 2018 Aug 1]. Available from: https://khn.org/morning-breakout/two-drug-epidemics-decades-apart-why-governments-response-to-opioid-epidemic-different-than-crack-crisis/.
  43. 43.
    Kolodny A, Frieden TR. Ten steps the Federal Government should take now to reverse the opioid addiction epidemic. JAMA. 2017;318(16):1537–8.CrossRefGoogle Scholar
  44. 44.
    Hull SC, Jadbabaie F. When is enough enough? The dilemma of valve replacement in a recidivist intravenous drug user. Ann Thorac Surg. 2014 May;97(5):1486–7.CrossRefGoogle Scholar
  45. 45.
    Centers for Disease Control and Prevention. Overcoming barriers to medication adherence for chronic diseases [web streming video]. Atlanta (GA): CDC; presented 2017 Feb 21 [cited 2018 Jul 30]. Available from: https://www.cdc.gov/grand-rounds/pp/2017/20170221-medication-adherence.html.
  46. 46.
    Hui K, Angelotta C, Fisher CE. Criminalizing substance use in pregnancy: misplaced priorities. Addiction. 2017 Jul;112(7):1123–5.CrossRefGoogle Scholar
  47. 47.
    Goodnough A. When an Iowa family doctor takes on the opioid epidemic. The New York Times [Internet]. 2018 Jun 23 [cited 2018 Aug 2]. Available from: https://www.nytimes.com/2018/06/23/health/opioid-addiction-suboxone-treatment.html.
  48. 48.
    Mendiola CK, Galetto G, Fingerhood M. An exploration of emergency physicians’ attitudes toward patients with substance use disorder. J Addict Med. 2018;12:132–5.CrossRefGoogle Scholar
  49. 49.
    Bartlett R, Brown L, Shattell M, Wright T, Lewallen L. Harm reduction: compassionate care of persons with addictions. Medsurg Nurs. 2013;22(6):349–58.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Goldin N. I survived the opioid crisis. Artforum International Magazine. 2018 Jan; 56(5). Available: https://www.artforum.com/print/201801/nan-goldin-73181.

Further Reading on this Topic

  1. Bergman EJ, Diamond NJ. Sickle cell disease and the “difficult patient” conundrum. Am J Bioeth. 2013;13(4):3–10.CrossRefGoogle Scholar
  2. Quinones S. Dreamland: The true tale of America's opiate epidemic. New York, NY: Bloomsbury Press; 2016.Google Scholar
  3. Reading N. Methland: the death and life of an American small town. New York, NY: Bloomsbury; 2009.Google Scholar
  4. Verghese A. The tennis partner: a doctor's story of friendship and loss. New York, NY: HarperCollins; 1998.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Theresa Baxter
    • 1
  1. 1.Department of Nursing/AnesthesiaSUNY Upstate Medical UniversitySyracuseUSA

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