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The results of a survey on nurses' perception of their knowledge and confidence of prescription opioids,  conducted by Varona, Payne-Borden, & Franckowiak (2017), found that nurses believe they are knowledgeable enough about opioids and are confident they can use their knowledge to  educate patients. Although,  a similar study done found, "a deficit in pharmacology of pain medications particularly narcotics...[and] 24% of nurses lack knowledge in distinguishing between toleranece and dependance" (Nuseir, Kassab, & Almomani, 2016).

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According to Barth et al. (2013), the use of prescription opioids for non-medical purposes can have  lead to unintentional overdose, physical and mental health problems, and increased expenses (Barth, Maria, Lawson, Shaftman, Brady, & Beck, 2013).
Farr, J. (2012)

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Advocate for more research to develop abuse deterrent formulations of pain medications. The ANA (2017), suggests this is an important tool in combating abuse

Alliance for Patient Access. (2015).

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A Prescription for Reducing Opioid Abuse

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The use of screening tools to determine at-risk patients such as The National Institute on Drug Abuse (NIDA) Quick Screen and  the NIDA-Modified ASSIST - A series of questions is asked, a score is determined and proper action can be taken

(NIDA, 2012).

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In the context of the nurses role in combating opioid addiction, I've learned that nurses are the number 1 advocate for the patient. As it pertains to  leadership, advocacy goes beyond advocating for the needs of the individual patients, but also advocating for change in the current practice setting. In the context of opioid addiction itself, I feel that subject was touched upon at times but never went beyond signs and symptoms. However, making use of the knowledge I acquired on using evidence based practice and research, this could possibly be something to push for once I get out into the field.

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Educational training in SBIRT- Screening, Brief Intervention, Referral to Treatment;  improves clinical skills in recognition and early intervention for substance abuse

(SBIRT, 2015).

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SBIRTTraining.com is designed to positively impact patient outcomes in the realm of substance use by providing an effective training in SBIRT skills for healthcare providers. In addition to providing the knowledge and skills needed, the activity provides the opportunity to practice skills learned through interactive case vignettes.

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A study conducted by Butler et al. (2016), found 31 of 35 patients reported the time of onset for using prescribed opioids for non-medical uses to be:

6 months of occasional use to get high

12 months of regular use to get high

18 months of use to avoid effects of withdrawal

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Nurses are often the first and last person a patient sees while seeking care. As health care providers practicing on the front lines of the opioid epidemic, nurses are qualified to play a leading role in assessing, educating,  and managing patients battling prescription opioid addiction. As Manworren & Gilson (2015) stated, "nurses have the opportunity to provide patients with anticipatory guidance related to prescription medications, teaching them about the risks of opioid diversion and providing information on the safekeeping and proper disposal of opioids that are no longer needed". Although nurses are tasked at educating patients on the use of opioid medications, the teaching usually stops at administration instructions. This shortcoming puts the patient at risk for unintentional negative consequences. According to Costello (2015), a study of 391,139 "opioid-naive" patients  who underwent  surgery, found "those who received an opioid prescription within seven days of surgery were 44% more likely to become long-term opioid users within one year".
One of the biggest barriers the nurse encounters is a lack of knowledge. Costello (2015), found that nurses do not have enough knowledge of opioids to provide patients with adequate instruction on safe home medication management and fewer than one-third of 314 nurses (29%) at two major medical centers knew how to correctly store and dispose of excess opioids.

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CDC. (2017)

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Prescription opioids continue to contribute to the opioid overdose epidemic in the United States.  In 2016, more than 40% of all  opioid overdose deaths  involved a prescription opioid (CDC, 2017a).  As the prescriptions of opioids multiplies so does the likelihood of abuse.  According to the CDC's Prescribing Data (2017b), prescribing rates are highest among pain medicine (49%), surgery (37%), and physical medicine/rehabilitation (36%). Furhtermore, more than 1,000 people are brought to an emergency room everyday day for medical consequences related to prescription opioid abuse (CDC, 2016).  Some of the most common prescribed opioids include methadone, morphine, meperidine, fentanyl, oxycodone, and hydrocodone (CDC, 2017b).  Addiction can happen to anyone, at any time, however according to the CDC's Prescription Opioid Overdose Data (2017c),  overdose rates were highest among those aged 25-54 years, non-Hispanic whites, and men.