Opioid use in pain management for oncology patients Ashley Newhall Wilmington University Opioid use in pain management for oncology patients In 2016 the Center for Disease Control and Prevention reported 42

Opioid use in pain management for oncology patients
Ashley Newhall
Wilmington University

Opioid use in pain management for oncology patients
In 2016 the Center for Disease Control and Prevention reported 42,249 deaths involving opioids. This statistic is alarming and is bringing attention to a public health issue that is at the forefront of current healthcare initiatives. Likewise, cancer rates in the United States continue to rise. Cancer is now the second leading cause of death in the United States and with that comes disease complications that require specialized treatment such as pain management.
The human body has a complex pathway to transmit pain signals from the site of tissue injury to the brain. Along this pathway there are endogenous opioid receptors, these receptors bind to naturally occurring endorphins and decrease the sensation of pain. “Opium” a substance derived from the Opium Poppy plant has been used since ancient times for pain management because it binds to the opioid receptors in the body much like endorphins do. Modern medications which originated from this plant and are commonly used in oncologic pain management are Morphine and MS Contin. These medications came with many problematic side effects such as constipation and respiratory depression and as pharmacology advanced they began creating synthetic forms of these drugs such as fentanyl hoping to eliminate the negative side effects. Opioids are prescribed in cancer related pain when non-pharmacological interventions are found to be no longer helpful without conjunctive treatment.
Pain management includes “the interaction and integration of biochemical, social, psychological, social and cultural factors” (Gordon, Corcoran, Bartley-Daniele, Sklenar, Sutton, Cartwright, 2014). A complex issue that requires a multidiscipline approach, many institutions have a designated team of professionals who share a common goal to help patients manage conditions and maintain function to the best of their ability. The 2017 Joint Commission requirements now include standards that state a team, or leader is required to take responsibility to treat a patient’s pain to avoid the over prescribing of opioids as well as the under treatment of pain (Joint Commission Perspectives, 2017). These teams have lead to increased positive patient outcomes as they respect each team members expertise and skills and work together to safely manage pain and achieve a common goal.
This basic introduction of opioids and pain management will lay the foundation to discuss how the fear of opioid misuse has created a barrier in oncology nursing. We must overcome these barriers with evidence based practice in pain management practices. The research indicates patient and staff education on safe opioid prescribing methods as well as the utilization of professional pain and palliative care teams has greatly reduced the cases of opioid abuse in the oncology population.
References
Gordon, R. M., Corcoran, J. R., Bartley-Daniele, P., Sklenar, D., Sutton, P. R., ; Cartwright, F. (2014). A Transdisciplinary Team Approach to Pain Management in Inpatient Health Care Settings. Pain Management Nursing, 15(1), 426-435. doi:10.1016/j.pmn.2013.01.004
Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. (2017, July). Joint Commission Perspectives, 37. Retrieved from https://www.jointcommission.org/assets/1/18/Joint_Commission_Enhances_Pain_Assessment_and_Management_Requirements_for_Accredited_Hospitals1.PDF