Edward Kim, Kyrah Barrow, James Danh: Cohort 10 LVN to BSN
Melissa Muddell, MSN/Ed, RN (Faculty Advisor)
Azusa Pacific University
“Nonpharmacologic therapy and nonopioid
pharmacologic therapy are preferred for
chronic pain. Clinicians should consider effective manner. Current treatment of Chronic
opioid therapy only if expected benefits for
both pain and function are anticipated to
the deaths of many people with little evidence
outweigh risks to the patient. .”
of its effectiveness. The health care industry and
Study Background: Krebs, Gravely, Nugent, et al
(2018) in the Journal of the American Medical
Association published a study that attempted to
answer if opioid medication was more effective than
nonopioid analgesics for chronic pain. The randomized
clinical study consisted of 240 participants with
moderate to severe chronic back pain or hip or knee
osteoarthritis pain over a 12 month period. The group
was divided into two groups, one receiving opioid
analgesics and the other receiving nonopioid
analgesics. Participant reported pain-related function
and pain intensity (0-10 with higher scores being
worse) were the measured outcomes.
Results: Mean Pain-related function over the 12
month period for opioid users was 3.4 and 3.3 for
nonopioid users. Mean pain intensity for opioid users
was 4.0 and 3.5 for nonopioid users. No Significant
difference in pain related function for both groups,
with higher pain intensity for the opioid group. The
opioid group reported more adverse effects.
Patient Reported Pain-Related Function, Pain Intensity, and Adverse Outcomes Among
Patients with Chronic Back Pain or Knee or Hip Osteoarthritis Pain Randomized to Opioid
vs Nonopioid Medication (Published March 6, 2018)
Baseline 3 Month 6 Month
Opioid Group Mean Pain 5.4 3.7 3.4
Related Function
Nonopioid Group Mean 5.5 3.7 3.6
Pain Related Function
Opioid Group Mean Pain 5.4 4.3 4.1
Intensity
Nonopioid Group Mean 5.4 4.0 4.1
Pain Intensity
Opioid abuse has been a major health concern for the
past couple of years. New strategies and research is
needed to improve client outcomes and reduce adverse
effects. Nurses and providers needs to balance the
responsibility of relieving pain with reducing the risk of
harm to the client. No conclusive research has shown the
effectiveness of opioids in the treatment of chronic pain
with recent research showing it to be no more effective
than nonopioid pain relievers with far more adverse
outcomes and risks. This is a problem that was created
health care and it is up to nurses and health care
providers to advocate for change and educate the public
about the dangers of long term opioid use.
School of Nursing
America is currently experiencing an opioid
epidemic, with overdoses and death by opioids
Chronic pain needs to be treated in a safe and increasing sharply since 2010. Drug overdose is
the leading cause of accidental death in the US,
pain using opioids has endangered and led to
with 63.1% due to opioids in 2015. A major cause
is the over prescription and treatment
mismanagement of chronic pain conditions with
nurses must use alternative treatments and
educate the public on its dangers opioids with 214,881,622 opioid prescriptions in
2016 a rate of 66.5 per 100 persons. Opioid
effectiveness in the treatment of chronic pain is
being questioned due to current research.
Death by Drug Overdose 2014 - 2017
2014 2015 2016 2017
Drug Overdoses
47,055 52,404 58,525 66,972
(all types)
All Opioids 28,647 33,091 38,075 44,868
Heroin 10,574 12,989 14,681 15,365
Natural and Semi-
12,159 12,727 13,698 14,482
Synthetic Opioids
Methadone 3,400 3,301 3,393 3,106
Synthetic Opioids 5,544 9,580 14,417 24,570
To ensure opioids are used effectively, evidence based practice
must be implemented. Individual clients should be assessed
and given treatment that is specific to their needs. Thorough
assessments should be performed, identifying and treating the
underlying cause of the client’s complaint. Customized
treatment specific to the needs of the client should be
9 Month 12 Month implemented instead of issuing a one size fit all drug.
3.6 3.4
Additional treatments such as holistic treatment, physical and
occupation therapy should be used to treat clients with chronic
3.3 3.3
pain. Nonpharmacologic and nonopioid treatments should be
the first line treatment for chronic pain. It is imperative to
4.2 4.0
educate health care workers who treat clients with chronic
3.6 3.5 pain. Opioid addiction and its hazards must be emphasized
within nursing curriculum. Nurses must educate clients on
abuse and addiction of opioids. The well informed nurse is a
valuable tool to fight the opioid epidemic. Additional research
must be done to identify safe non-addictive treatments.
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