Welcome to Journalphoria, an on-line Journal Club created to increase dialogue and critical thinking skills between nurses, using Oncology related topics and articles. For a Journal Club first timer, here's how it goes - Sign up for a
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and allow you to access Journal Club articles anywhere and anytime. Use your
work computer, smart phone, tablets or home computer. Once your
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posts, and to reply to the posts of other Journal Club members. If you sign on as a follower, you will be able to receive updates from the blog.
There will be two to three questions after each posting, your answers need
to be sent to; melissa.luebbe@ctca-hope.com . It is VERY important
that your responses include your full name, the unit you work on, and contact
information. Each response should be written in a professional manner
that includes at least two full sentences. To receive full credit
you must also respond to the discussion question on the blog. New this
year is the requirement that you reply to one other response posted by another nurse on the
discussion blog. When you are blogging, please remember on-line courtesy and
HIPAA! Another important point to remember is that there are no wrong
answers. The questions ask you to use your nursing experience and
critical thinking skills. The questions also offer you the opportunity to practice teaching points that can be used in your practice.
For our first Journal Club article of the year, I chose a topic very near
and dear to my heart; Assessment and Management of
Cancer Related Pain. Cancer-related pain
affects 20% to 50% of patients at the time of their diagnosis and during
subsequent treatment, and 55% to 95% of those in the advanced stages of their
disease. (American Cancer Society, 2013).
Oncology nurses play a very important role in supporting and educating
patients about their pain and pain treatment plans. Pain affects patients
physically, psychologically, socially, and spiritually. By increasing
your knowledge of cancer related pain you can improve how you assess and educate
your patients, thereby helping them to improve the quality of their lives.
Questions:
1. Who is Margo MacCaffery, and what is her most famous quote?
2. What would you tell a patient about potential side effects from their recently prescribed
opioid medication?
3. You are working with a patient who has constant malignant pain. This patient works in
the construction industry and operates heavy equipment. What could you discuss with
him as possible alternatives to taking opioid medication for his pain?
1. Who is Margo MacCaffery, and what is her most famous quote?
2. What would you tell a patient about potential side effects from their recently prescribed
opioid medication?
3. You are working with a patient who has constant malignant pain. This patient works in
the construction industry and operates heavy equipment. What could you discuss with
him as possible alternatives to taking opioid medication for his pain?
Discussion Question: A patient that you encounter is reporting constant 8/10 cancer related pain that is affecting their ability to sleep, go to work, or socialize with friends and family. The patient tells you that they fear becoming addicted to their pain medication. How would you educate and give support to their concern?
References
www.cancer.org, 2013.
References
www.cancer.org, 2013.
I would inform the patient that becoming “addicted” to pain medication is a common concern for cancer patients. I would inform the patient that drug addiction in cancer patients is rare. It may be common to develop an increased tolerance for a drug but becoming physically dependent on a drug for pain relief does not mean that you are addicted. I would reinforce to the patient that staying on top of their pain medication will help them with maintaining their quality of life.
ReplyDeleteI tried to find some data as too the number of cancer patients that actually become "addicted" because I agree with you the incidence is so rare that it really need not be a concern for this patient population however, I know it frequently is. It is really too bad that this fear is as prominent as it is because it prevents many patients from receiving adequate pain control.
DeleteI agree with Debbie , it just sad that because of their fear of addiction ,it hinders them of having enough pain medication that is essential in their quality of life.
DeleteAlthough the patients may be fearful of addiction, most of the time they are fearful of their pain as well. It's a decision only they can make, whether to be in pain and alter their day to day lives because of it or take the risk that their body quite possibly can raise it's tolerance for pain meds resulting in them needing more. Tough decision.
DeleteI agree with Tina,good pain control=better quality of life.
DeleteI would inform that that, although a common concern for all people, pain medication is a necessity for them to have a work/life balance due to the level of pain that they are in. Medical professionals can always ween them off the medication once their pain is better controlled and the cancer is treated (the source of the pain).
ReplyDeleteThank you Kari for mentioning the work/life balance. I think many times patients are so concerned about becoming addicted to the pain medication that they their work/life balance suffers. And I agree it is important to remind the patient that once the pain medication is no longer needed they will be weaned off by a medical professional. Besides the fear of becoming addicted I think they also fear withdrawl.
DeleteI agree that it is important for the patient to have work life balance. I would educate them on the need to take the medication as prescribed and to update the doctor's office if the pain is not controlled at a tolerable level. I would educate them that addiction to pain medication is rare in cancer patients and let them know that our goal is to control the pain and allow them to function in their lives with the least amount of distraction from it due to pain. I would educate them to inform us if they feel their pain is under better control as treatment continues and tumors shrink, when treatment completes etc...so that their medication can be slowly weaned. I would provide them with other tools and resources such as relaxation techniques. I would also offer the patient support because the current pain level of 8/10 may require additional pain medication, changes in pain medication or an addition of an anti-anxiety medication to assist with decreasing this pain level. This patient may need follow up calls to assess his/her pain levels and verify that the medications are being taken and the they are trying other techniques such as relaxation or redirected thinking.
DeleteEducation is a tool I would use in an encounter where a patient expresses both constant, severe pain, as well as their reluctance to take pain medication for fear of becoming addicted. I would first emphasize that quality of life is paramount when living with cancer and the way to combat pain is to stay on top of it with medication. I would also try to explain the difference between physicial dependence and addiction. The former is often expected and can be described as building a tolerance to narcotics. It can also be managed well and a physician can ween a patient off of pain medication slowly as to avoid withdrawl symptoms. Addiction is thought of as more of a behavioral issue where a person decides to use a substance for unintended purposes or continues its use despite negative consequences. I would stress to to the patient that this can all be managed by clinicians who have experience in this area. I would assure them that we would monitor their pain experience and medication closely and encourage them to adhere to a pain regimen in order to regain quality of life.
ReplyDeleteYou nailed it Kelly! Educate Educate Educate! I also liked that you pointed out that if the time came for them to be off the pain medications that they would be weened in order to avoid withdrawl symptoms.
DeleteIf I had a patient experiencing constant pain 8/10 cancer related pain who expresses fear of becoming addicted to pain medication I would first validate their concerns. Education appropriate to their level of understanding and comprehension is critical. I would explain the potential risks of not managing the pain and the negative impact of their quality of life. I would make sure the patient understands “how” and “when” to use the pain medication safely with the goal of reducing the pain level and improving quality of life. I would reassure them the risk of addition is minimal and the importance of managing the pain is the priority.
ReplyDeleteI agree with Debbie Gossen that sometimes patients do fear addiction and the Reluctant to take adequate medication for pain relief. See prior comment.
DeleteDebbie,
DeleteGood point in educating according to their level of understanding and comprehension. Sometimes constant reinforcement and educating family members is vital to the adherence of the patient's pain regimen.
I would inform the patient that drug addiciton is rare in cancer patients, though I do agree with previous comments that it is a common concern for cancer patients and for some practioners. I would let the patient know they should take the medications as prescribed for adequate pain relief and functioning. The benefits would be decreased pain ,improved sleep and emotional well being. I would encourage the patient and family not to fear and know there are ways to maximize pain relief. I would also discuss the concept of tolerance vs adiction in ways the patient can relate to. The patient should not be in pain if at all possible or needs to have adequate pain regime that provides optimum relief.
ReplyDeleteThis comment has been removed by the author.
DeleteHi Nancy, I liked your response about how fear of addition to narcotics are a "common" concern for patients. I hope our education can have an impact on patient's decision making when managing their pain to ultimately improve their quality of life.
DeleteOnly <1% of patients become addicted to pain medication. Typically, if a patient is going to become addicted to patient medication they already have been addicted to other substances. So it’s not the pain medication that creates the addiction, it’s the person’s mental stability. Are you currently having any problems with anxiety or depression at this time?
ReplyDeleteI agree that there is usually some addiction history involved when a person becomes addicted to pain medication. My question is how do help educate the former addict about pain control? They need to control the pain with the medication and usually due to past drug abuse end up needing higher doses of narcotics. A patient who has drug abuse in there history and has been sober for years has a very vaild point regarding future drug addiction.
DeleteI would explain that drug addiction is rare in a cancer patient, and that although a patient may develp a higher tolerance for a drug and may become physically dependnat on that drug, it does not mean he/she is addicted. Most true addictions involve a strong psychological component
ReplyDeleteMary, this is true. We recently had a patient (non-oncology) for GI procedure. When called on followup check, he specifically asked that a certain narcotic be prescribed for generalized aches and pains. I remember his comments while recovering from the GI procedure about "how wonderful the drugs (sedation) were." This is the type of patient that is prime for problems with addiction.
ReplyDeleteI would let them know that it is a common concern for most people who are taking pain medication and sometimes they need a higher dose of medication but it does not mean they are addicted.I believed that the more educated they are about this issue the better they will be in managing their and pain and lesser fear
ReplyDeleteI agree and definitely believe that education is key in order for a patient to best manage their pain and ultimately their quality of life.
DeleteI would tell the patient that taking pain meds for relief of pain is not addiction. It is a way to maintain quality of life. And that the pain meds should be taken as directed and if they are not effective to seek medical attention.
ReplyDeletei agree that taking pain meds for relief of pain is not addiction cause it's very rare in cancer patients. and if the pain meds is not effective, the patient needs to go back to the doctor who prescribed the meds to make the necessary adjustments to the dose.
DeleteI agree with you Victoria, emphasizing good pain control by following direction will restore patient's quality of life, especially if we add adjuvant therapies like what we use in our facility.
DeleteI would show that I understand that this is a concern for them as it is for many patients. I would explain that drug addiction for cancer patients is rare. I would encourage the fact that they would not be taking the medication if they were not having pain and that for many people with addictions there is a deeper cause. I would also reassure them that there will be close monitoring and follow up for them and that we as clinicians are all here to help and support them with dealing and managing their pain.
ReplyDeleteGreat post Andrea,
DeleteI think you hit on a key point in your first sentence. Recognizing that they have real concerns is important. I like that you would say that they will not be taking pain medications if they were not having pain. when I run accross patients like this as I illustrated in my post, I think it is best to get them involved with pain management as they have greater experience at correcting these concerns.
If a patient comes to me and said that pain scale is 8/10, I would encourage the patient to take pain medication as ordered on fixed schedule. If patient expresses concern to being addicted, I would educate the patient that pain medication is a necessity if he/she wants to manage pain from getting worse. The doctor will prescribe med to achieve a good balance between pain relief and side effects by gradually adjusting the dose. The correct dose is the amount of opioid that controls pain with fewest side effects. Addiction is rare in cancer patients. I would also explain to the patient that he/she is not alone in her experience and that we have a good pain management team in our hospital that will monitor patient’s pain regimen to maintain quality of life.
ReplyDeleteI agree with you. I like how you expanded your answer to include our pain management team here at CTCA and the sense of support that our hospital staff provides to our patients.
DeleteIf a patient reported constant 8/10 pain to me that was having such a negative impact in their quality of life as well as a fear of becoming addicted I would actively listen so that I could validate their concern. I would then educate the patient that it is very rare for cancer patient to become addicted to a pain medication that they are taking as prescribed by a trained physician. I would also assure the patient that our pain management team are well trained to identify signs of addiction should in a rare instance that occur. I would also inquire if the patient is aware of the difference between addiction and physical dependence or tolerance. If not, I would educate them on the difference. I would lastly encourage open discuss on how not taking the pain medication has had a negative impact on their quality of life. I would reassure the patient that as part of their health care team we want them to have the best care possible which includes adequate pain control and the best possible quality of life as they tend to go hand in hand.
ReplyDeleteRachel- I agree with you. It is important for the patient to know adequate pain control is important. He doesn't need to live his life in such severe pain. I like that you suggested explaining the difference between addiction, tolerance, and physical dependence. I had not thought of that. It would be important for him to understand those terms so he is aware of what TRUE addiction is.
DeleteI agree with Kelley H's statements. Just last week I discussed with a patient the difference between addiction and dependence and outlined the positives of maintaining adequate pain control and quality of life. Stressing adequate opioid tapering, with recommedations from clinicians, will prevent uncomfortable physical dependence withdrawal when & if reduction in dosing is appropriate. Reinforce to patients that they are not alone in their pain management struggles as they have the pain team, care managers, nurse navigators, floor nurses, radiation nurses, mind & body staff, physical therapy & rehab staff, and psychiatry, all as resources for pain management.
ReplyDeleteI agree with all who have posted, but would add that when a patient does have a prior history of drug misuse, we have to remember that often they may need and tolerate a higher dose of medication to control pain. And as caregivers, to be understanding and compassionate with them.
DeleteAs many of my peer's have stated, education is necessary in helping this patient to understand and accept the notion that addiction is very different than tolerance to a medication. But, I would also add in my education how cancer pain is different than somatic or injury type pain and the need to keep this type of pain under control is crucial for their recovery. Uncontrolled pain reduces the bodies ability to heal and fight for recovery, which can hinder their ability to respond to cancer treatments.
ReplyDeleteDebra, I think your answer hits right on! Patients need to realize that controling their pain improves their sleep, appetite, and quality of life in addition to recovery of their cancer. I think the fear of addiction is based on societies view of people who use pain mediction.
DeletePerfect. You are so Right. Cancer vs other pain! Today is the day to live and not the future for some of our patients. Feel comfortable to enjoy what is important today b/c it might be gone tomorrow. Words we all should live by.
DeleteI would let the patient know that I understand what his concern is and educate him on cancer related pain. I would let him know the chance of addiction is small and the need for the medications to help him live a good quality life outweigh the risk of becoming addicted. He needs to know that it is possible for him to have pain control without becoming addicted and he doesn't need to live in pain for the rest of his life. Reminding him that we are always available throughout his journey if he feels he is losing control of his pain.
ReplyDeleteI agree with Kristi! Validating the patients concern is key. Education then becomes crucial in our day to day encounters, and reinforcement is often necessary. No one should have to "just deal with pain."
DeleteI agree with Kristi on the education and how to live a good quality life that outweighs the risk of becoming addicted.
DeleteI like that jtcastro says that the correct dose is the dose that controls pain and gives the fewest side effects.
ReplyDeleteThis is an interesting comment, and is applicable to any prn medication, really. Patients always ask us: "How often should I take X," or "How much X should I take?" Well, the answer is: the dose and frequency, as prescribed, which does the job without harm.
DeleteEducate the patient that he is using the pain medication for legitimate reasons and not for the "high" that some abusers use and then become addicted to narcotics for. Acknowledge the fear and help the patient move forward to help themself.
ReplyDeleteEducation will be key in helping patients understand the difference between addiction and physical dependence/tolerance. Such as, the compulsive use of a drug for it's mood altering affect (despite harm) vs a normal physiological response as a consequence of chronic opiod use. I would reinforce that when used correctly opiods are capable of effectively managing pain and thus allow individuals to live a "normal life."
ReplyDeleteI would address the concern and made patient understand the importance of good pain control. That the possiblility of addiction for oncology patients is low due to the cause,severity or intensity. That it is important to take pain medication round the clock to maintain blood levels. In fact, I would remind him to take break through doses
ReplyDeleteif prescribed. It will him to function and carry ADL's. Also we could advise him to seek
adjuvant therapy like physical interventions (massage, accupuncture), thinking, behavioral & psychosocial interventions (imagery, hypnosis, relaxation, reike), like what we do in our facility CTCA @ MRMC.
Imelda, I agree it is so important to take the pain medication around the clock and stay ahead of the pain. I also really like the idea of incorporating non-pharmacological methods of pain control. For some patient's this is very beneficial and also reassuring to them they they have move control over the pain than just taking a pill. Treating the whole patient is especially important with cancer pain since it can have systemic effects.
DeleteWhen pain is addressed with new patients many times their biggest fear is addiction. Once the doctor explains that pain control will improve their sleep, appetite, and quality of life patients are more receptive. We also educate that pain medications will be adjusted as thier cancer improves or progress's. Pain blocks are also effective in eliminated the need for oral pain medications and many patients benefit from them. Education and clarification of pain medication and its use in treating cancer pain is usually enough to get patients on board with a regimen. Education on constipation should also be done when starting a new pain regimen.
ReplyDeleteIf I had a patient that had a constant pain of 8/10 but was fearful of becoming addicted to pain medications, I would educate the patient on taking the dose before the pain starts. I would explain that the medication wears off after a period of time and that if the next dose was given closely to the time then the pain may not be so debilitating. In this case it would seem that the pain medication is still effective because the patient is not waiting for the pain to be unbearable before taking the medications. This would be the instance that the patient may possibly have the dosage increased assuming that what they have is not enough.
ReplyDeleteI would also tell the patient that proper pain control helps reduce the amount of stress on their body. Constant pain is stressful and exhausting for our bodies and removing or reducing that pain helps the body by allowing more energy to go towards fighting their cancer.
ReplyDeleteI would explain to the patient that taking pain meds for pain control is not an addiction. Patient needs to take pain meds as prescribed to control pain and they will in turn have a better quality of life.
ReplyDeleteYes, Malgorzata I agree with you. Better pain control will lead to a better quality of life.
DeleteThis concern is a common reported concern for patients who are being started on opioid medication for pain. I would educate them that unless they have a history of drug abuse and addiction only about 3% of patients using opioid analgesics for chronic pain develop addiction. I would go on to explain that addiction is often characterized by the repetition of an activity to an extreme that it begins to cause dysfunction in other areas of a person’s life such as social isolation, inability to carry out functions and responsibilities of daily living due to preoccupation with acquiring and using the addictive substance. Often times patient’s will confuse increased tolerance with a sign of addiction. It should be explain that this is not the case and that Opioid analgesics are the gold standard for pain management due to the fact that there is no ceiling to how much opioid analgesic can be administered for pain. The objective of taking the opioid analgesic is to relieve pain such that the person will experience and improved functional status, experience less social isolation, and improve sleep and rest quality.
ReplyDeleteAs a professional nurse I would also consider that patients often have other reasons for not wanting to start opioid analgesic therapy and may use the excuse of fear of addiction to avoid opioid it. Some of patients are a concern that opioid analgesics are the beginning of the end, and may indicate a change of focus from cure to palliation. The patient may fear that their Oncologist will start to see that pain management is more of a priority that curative therapy.
This is a great topic and it is right on time for me! This week I had a patient that I could see looked to be pretty uncomfortable and only rates his pain at a 2-3, however the patient states that he had already been experiencing problems with sleep. I discussed my concern with the physician and was allowed to offer 2 mg of morphine IV push for pain. When I offered the patient was willing and the spouse looked very concerned and said “are you sure”. Inquiring, I asked and they said that they were concerned about addiction. I instructed them as above and the spouse began to cry “It’s Just that it’s the strong stuff”. I cannot help but wonder if the underlying issue was that by taking morphine for analgesia they were by proxy resorting to palliative care versus curative treatment. It was clear to me that while the patient’s pain management was uncomplicated by large doses of medication becoming non-effective or multiple types of pain, he could benefit from a visit to pain management for educational reinforcement if nothing else. A Pain management consult was obtained and the patient was instructed to medicate his pain as prescribed and document on a pain diary which he would bring to the consult.
I think the best way to dispel this patient's fear and allow for better control of their pain is through educating them. It is very important to listen to the patient, and assess why they fear they will become addicted. Perhaps the patient or one of their close family members/friends has struggled with addiction in the past, they have heard the myth from other people, or even a healthcare member has expressed this concern to them. Discussing the cause of their fear, would help me best support the patient and focus my education.
ReplyDeleteIf a patient is concerned about becoming addicted to his/her pain meds, I truly do believe that the best way for them to understand something like this is to educate them. The best thing to do is to assess the patients pain level and then ask them if they are truly using the pain meds for the right reason(cancer pain and is it helping, or just to get a high). If a patient is using his/her pain meds correctly, then there shouldnt be a problem. I would recommend to the patient to always stay in contact with the pain management team to help them through any concerns, and also maybe offer if the patient ever wanted to do any alternative measures(ie: accupuncture, nerve block, relaxation....)
ReplyDeleteI agree with your statement and I think staying in touch with pain management is a good idea.
DeleteI would inform the patient that there are many different strategies to pain management. I would tell the patient that we will work with them and their preferences. I would tell them that we would constantly monitor their pain management and their response to the treatment they are receiving. I would also let the patient and family know that drug addiction is very rare in cancer patients. The patient may become tolerant, and therefore require a higher dose or different medication, but that does not mean that the patient is addicted (cancer.org, 2013)
ReplyDeleteMany of my patients fear taking their extended release opioids such as oxycontin at their regularly prescribed times. They fear that it is too much medication; they fear they will become addicted, and they fear they will not be able to function. Again, I tell the patient that we are constantly monitoring them, that in most cases the body will adjust to the opioid and they will be able to carry out their day to day activities. Education is definitely key to fearful patients. I find myself encouraging my patients frequently to not skip a dose of their long acting pain medication. I tell them that we are aiming for pain relief and hopefully they will not need to use their breakthrough medication as often. Sometimes constant reminders and encouragement is what is needed to help patients face and move past their fear of taking their pain medication.
Reference:
www.cancer.org 2013
Jennifer Wise September 30, 2013 at 9:45 AM
ReplyDeleteThe patient should be educatuted and have more understanding on how to control their pain. I know some patients are afraid that they would become addicted to their pain meds. But what is more important is to control their pain and be able to function as normal as possible. When a patient is in to much pain they normally will not eat, get enough rest,and become more depressed because they can't fucntion like they use to. I encourage them to take their medications to lead as normal and pain free life as prior to their diagnosis.
I totally agree with Jennifer the patient needs to understand that by controlling his pain he will be able to do more of his daily activities and live as close to a normal life as possible.
DeleteThe patient should be reassured that needing and using his pain meds will not necessarily make him addicted to them. But it will help him feel better. Also the patient should be educated in other methods used for pain control like massage therapy, accupunture therapy, reiki therapy etc.
ReplyDeleteThe patient should be allowed to express their concerns and fears. The nurse should acknowledge these fears and concerns and inquire of any past history of abuse or addictive behaviors have occurred. Then the nurse should educate the patient on how the medications are designed to work if taken correctly. Reassurring the patient that sometimes these medications are needed for situational or temporary purposes and can be decreased or increased depending on how the patient is feeling.
ReplyDeleteSheila, great job on opening the dialogue and letting the patient express their concerns before going into the education and teaching mode as a nurse. Active listening is a crucial part of a patient's cancer journey.
DeleteIf a patient comes to me and is open about the fear of being addicted to pain medication, it will allow two things. To have an open discussion about if the patient had any addiction troubles in the past and education related to cancer pain. A pain level of 8/10 is causing interruptions to this patients life. I would discuss tolerance vs addiction and medication that are there to try beside narcs if the patient would like to start at that level first. The main goal is the patient to feel comfortable taking the medication and comfortable to live life
ReplyDeleteYou are so right in addressing the patients quality of life due to untreated pain from the fear of addiction. Helping our patients overcome their fear with education and compassion as you point out also is key in developing a trusting relationship with our patients.
DeleteWhen a patient is voicing the significant impact that their pain is having upon the quality of their life and is probably not taking the pain meds as directed due to their stated fear of addiction, the education & support that would be first for me would be to inform the patient that pain medication is prescribed to help improve the quality of their life. Then instruct the patient of difference between addiction and tolerance and assist the patient to take the medication as prescribed while reassuring the patient that the goal is to be able to function with the least amount of side effects.
ReplyDelete: A patient that you encounter is reporting constant 8/10 cancer related pain that is affecting their ability to sleep, go to work, or socialize with friends and family. The patient tells you that they fear becoming addicted to their pain medication. How would you educate and give support to their concern?
ReplyDeleteIn the above situation it is important to assess the pain and get as much information on the pain. Inform the patient the importance of controlling the pain to prevent other side effects of immobility. The goal of pain therapy is to give the patient a quality of life and help them to be comfortable and able to tolerate activity. Other measure may need to be examined to bring relief such as other treatments to reduce tumor load or nerve blocks.
I agree---With cancer patients, it IS all about the "quality of life" and keeping them comfortable. Well stated.
DeleteDiscuss the pros and cons between effective pain management relief and medication addiction. Then, it’s the patient’s right to make a decision as to what the next step(s) will be. As clinicians, we’ll always support any choice a patient makes in a non-judgmental compassionate manner.
ReplyDeleteI have been asked this before and I tell the patient if you are taking the medicine for pain relief you will not become addicted. It is when peopel start taking the pain medication for reasons other than pain, then that can become a problem.
ReplyDeleteI agree with your response. If patients take pain medication for pain and not for such things as anxiety or sleep then they are less likely to become addicted.
DeleteIt is crucial that a comprehensive history taking of patient's pain must be obtained. Every individual is unique in how each ould respond to pain management modalities particularly drug-related interventions. In this particular scenario, I bwould provide education that encompass the proper and correct usage of the medication. If the drug is used correctly, it is proven to be effective in relieving pain to most of cancer patients. I think it is also prudent for any provider to initiate education at the first dose of the medication. Some of patients would just endure their pain becasue of the irrational fear of addiction. This can be avoided if patients receive proper information ahead of time and as clinicians we should be proactive with educating our patients.
ReplyDeleteI think it important to acknowledge the patient's concerns, as addiction is real and a valid concern. I think its also important to educate the patient that most patients are not addicted and it is a small percentage who are. Over time long term pain medication use can lead to a body's increased tolerance against the medication, decreasing their effects and requiring a higher or more frequent dosage in order to achieve the same effects. If a patient says he is at an 8/10 on a pain scale, it is important to address what number is an acceptable level for him that would allow him to maintain quality of life. While pain medication has the stigma that it is addicting, it does however provide benefits that can help a patient live life to the fullest. I also would encourage that if a patient is concerned about overusing pain medication, that there are non-pharmacologic alternative therapies that can help relieve pain as well.
ReplyDelete