Ethical Aspects of Chronic Pain Management with Opioid Analgesics

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Ethical Aspects of Chronic Pain Management with Opioid Analgesics Pain has been identified as the most common reason that patients seek medical attention. It is estimated that nonmalignant chronic pain effects more than 50 million Americans. The World Health Organization has identified pain as a leading health problem in the county (Payne et al., 2010). Repeated studies have identified difficulty on the part of providers to manage pain to meet patient needs. Many patients with severe pain change health care providers at least once in the search of adequate pain relief (Casey, 2011). Opioid analgesics, including oxycodone, hydrocodone, codeine, morphine, and fentanyl, are among the most effective drugs for managing many types of …show more content…
Deaths related to opioid overdose in the United States occur more often than deaths related to heroin and cocaine combined. The rate of diversion of opiates by chronic pain patients is unknown but is estimated to be low (Payne et al., 2010).
Relevance and Applicability to Nursing Practice Pain is caused by both physiological and psychological processes and is mediated by a host of external and internal factors. Health care providers rely primarily on the patient's own report of pain when considering treatment options. Previous experiences, cultural norms, access to alternative coping mechanisms, along with a multitude of other determinants alter a person's perception of pain. The health care provider has the responsibility to interpret subjective data presented by the patient along with their physical examination. Treatment options must be considered by weighing the importance of effective pain management against associated risks.
Pain Assessments Of primary importance in treating pain appropriately is pain assessment. Oftentimes a unidimensional tool, such as a 0-10 numerical scale where 0 is no pain and 10 is the worst pain imaginable, is used in a hospital setting. Pain assessments should include the quality, location, and pattern of the pain as described by the patient. Multidimensional pain questionnaires explore the “sensory, affective, and emotional components of the patient's pain experience” (Cox, 2010). In the hospital setting,

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