Advertisement
Review| Volume 21, ISSUE 1, P35-42, February 2020

Nursing Education in the Midst of the Opioid Crisis

      Abstract

      Objectives

      The current opioid addiction crisis highlights two chronic health conditions which have traditionally received relatively little emphasis in nursing curricula: addiction and chronic pain. In an effort to provide direction to nursing programs in the US on the curriculum needed to prepare students to care for patients and meaningfully intervene in the opioid crisis, this paper presents an overview of the curricular elements which require integration.

      Design and Data Sources

      Specifically, the state of current nursing education in pain and addiction are reviewed, followed by foundational knowledge for nursing practice to address the opioid crisis.

      Review/Analysis Methods

      Practice competencies for generalist registered nurses as well as advanced practice nurses will then be detailed, and, recognizing the role nurses play in policy development and implementation, policy interventions to address the opioid crisis will also be presented.

      Result and Conclusions

      Both addiction and chronic pain are sources of suffering for patients; the key role nursing can play in reducing the experience of these illnesses in these vulnerable populations is critical to addressing the opioid addiction crisis.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Pain Management Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • American Academy of Nursing on Policy
        Opioid misuse epidemic: Addressing opioid prescribing and organization initiatives for holistic, safe and compassionate care.
        Nursing Outlook. 2017; 65: 477-479
        • American Association of Colleges of Nursing
        AACN’s response: The opioid epidemic.
        (Retrieved from)
        • American Association of Colleges of Nursing
        The essentials of master’s education in nursing.
        Author, Washington, DC2011 (Retrieved from)
        • American Association of Colleges of Nursing
        The essentials of baccalaureate education for professional nursing practice.
        Author, Washington, DC2008 (Retrieved from)
        • American Nurses Association
        The ethical responsibility to manage pain and the suffering it causes (2018 Position Statement).
        (Retrieved from)
        • American Nurses Association
        • American Society for Pain Management Nursing
        Pain management nursing: Scope and standards of practice.
        2nd ed. American Nurses Association, Silver Spring, MD2016
        • American Psychiatric Association
        Diagnostic and statistical manual of mental disorders.
        5th ed. Author, Washington, DC2013
        • American Society of Pain Management Nurses
        Core curriculum for pain management nursing.
        3rd ed. Elsevier, St. Louis, MO2018
        • Arizona Department of Health Services
        The Arizona pain and addiction curriculum.
        (Retrieved from)
        http://www.azhealth.gov/curriculum
        Date: 2018
        Date accessed: January 21, 2019
        • Association of Community Health Nursing Educators
        Essentials of baccalaureate nursing education for entry level community/public health nursing.
        (Retrieved from)
        • Briggs E.V.
        • Carr E.C.
        • Whittaker M.S.
        Survey of undergraduate pain curricula for healthcare professionals in the United Kingdom.
        European Journal of Pain. 2011; 15: 789-795
        • Campbell-Heider N.
        • Finnell D.S.
        • Feigenbaum J.C.
        • Feeley T.H.
        • Rejman K.S.
        • Austin-Ketch T.
        • Zulawski C.
        • Schmitt A.
        Survey on addictions: Toward curricular change for family nurse practitioners.
        International Journal of Nursing Education Scholarship. 2009; 6
        • Centers for Disease Control and Prevention
        Opioid overdose: Data overview.
        (Retrieved from)
        • Centers for Disease Control and Prevention
        Wide-ranging online data for epidemiologic research (WONDER).
        National Center for Health Statistics, Atlanta2017 (Retrieved from)
        • Centers for Disease Control and Prevention
        Today’s heroin epidemic.
        (Retrieved from)
        • Chandler G.E.
        • Kalmakis K.A.
        • Murtha T.
        Screening adults with substance use disorder for adverse childhood experiences.
        Journal of Addictions Nursing. 2018; 29: 172-178
        • Chou R.
        • Turner J.A.
        • Devine E.B.
        • Hansen R.N.
        • Sullivan S.D.
        • Blazina I.
        • Dana T.
        • Bougatsos C.
        • Deyo R.A.
        The effectiveness and risks of long-term opioid therapy for chronic pain: A systematic review for a National Institutes of Health Pathways to Prevention Workshop.
        Annals of Internal Medicine. 2015; 162: 276-286
        • Covington K.
        • Johnson J.A.
        • Henry D.
        • Calmers S.
        • Payne F.
        • Tuck L.
        • Seale J.P.
        Alcohol and drug screening and brief intervention behaviors among advanced practice registered nurse (APRN) students in clinical settings.
        Applied Nursing Research. 2018; 39: 125-129
        • Dahlhamer J.
        • Lucas J.
        • Zelaya C.
        • Nahin R.
        • Mackey S.
        • DeBar L.
        • Kerns R.
        • Von Korff M.
        • Porter L.
        • Helmick C.
        Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016.
        Morbidity and Mortality Weekly Report. 2018; 67 (Retrieved from): 1001-1006
        • Darnall B.D.
        • Juurlink D.
        • Kerns R.D.
        • Mackey S.
        • Van Dorsten B.
        • Humphreys K.
        • Gonzalez-Sotomayor J.A.
        • Furlan A.
        • Gordon A.J.
        • Gordon D.B.
        • Hoffman D.E.
        International stakeholder community of pain experts and leaders call for an urgent action on forced opioid tapering.
        Pain Medicine. 2019; 20: 429-433
        • Doorenbos A.Z.
        • Gordon D.B.
        • Tauben D.
        • Palisoc J.
        • Drangsholt M.
        • Lindhorst T.
        • Danielson J.
        • Spector J.
        • Ballweg R.
        • Vorvick L.
        • Loeser J.D.
        A blueprint of pain curriculum across prelicensure health sciences programs: One NIH Pain Consortium Center of Excellence in Pain Education (CoEPE) experience.
        Journal of Pain. 2013; 14: 1533-1538
        • Dowell D.
        • Haegerich T.
        • Chou R.
        No shortcuts to safer opioid prescribing.
        New England Journal of Medicine. 2019; 380: 2285-2287
        • Dowell D.
        • Haegerich T.M.
        • Chou R.
        CDC guideline for prescribing opioids for chronic pain—United States, 2016.
        Morbidity and Mortality Weekly Report, Recommendations and Reports. 2016; 65: 1-49
        • Duke G.
        • Haas B.K.
        • Yarbrough S.
        • Northam S.
        Pain management knowledge and attitudes of baccalaureate nursing students and faculty.
        Pain Management Nursing. 2013; 14: 11-19
        • Finnell D.S.
        • Savage C.L.
        • Hansen B.R.
        • Sanchez M.
        • White K.M.
        • Johnson J.A.
        • Seale J.P.
        Integrating substance use content in an "overcrowded" nursing curriculum.
        Nurse Educator. 2018; 43: 128-131
        • Fishman S.M.
        • Young H.M.
        • Lucas Arwood E.
        • Chou R.
        • Herr K.
        • Murinson B.B.
        • Strassels S.A.
        Core competencies for pain management: Results of an interprofessional consensus summit.
        Pain Medicine. 2013; 14: 971-981
        • Giron S.E.
        • Olson R.A.
        • Griffis C.A.
        • Compton P.
        The opioid crisis and the certified registered nurse anesthetist: Caring for patients with opioid use disorder in drug-free recovery.
        AANA Journal. 2018; 86: 82-87
        • Graham C.D.
        • Gouick J.
        • Krahé C.
        • Gillanders D.
        A systematic review of the use of Acceptance and Commitment Therapy (ACT) in chronic disease and long-term conditions.
        Clinical Psychology Review. 2016; 46: 46-58
        • Hamnvik O.R.
        • Alford D.P.
        • Ryan C.T.
        • Hardesty I.T.
        • Drazen J.M.
        NEJM Knowledge+ Pain Management and Opioids—A new adaptive learning module.
        New England Journal of Medicine. 2019; 380: 1576-1577
        • Herr K.
        • Marie B.S.
        • Gordon D.B.
        • Paice J.A.
        • Watt-Watson J.
        • Stevens B.J.
        • Bakerjian D.
        • Young H.M.
        An interprofessional consensus of core competencies for prelicensure education in pain management: Curriculum application for nursing.
        Journal of Nursing Education. 2015; 54: 317-327
        • Jonas W.B.
        • Schoomaker E.B.
        Pain and opioids in the military: We must do better.
        JAMA Internal Medicine. 2014; 174: 1402-1403
        • Jones C.M.
        • Einstein E.B.
        • Compton W.M.
        Changes in synthetic opioid involvement in drug overdose deaths in the United States, 2010-2016.
        JAMA. 2018; 319: 1819-1821
        • Kerr T.
        • Mitra S.
        • Kennedy M.C.
        • McNeil R.
        Supervised injection facilities in Canada: Past, present, and future.
        Harm Reduction Journal. 2017; 14: 28
        • Knopf-Amelung S.
        • Gotham H.
        • Kuofie A.
        • Young P.
        • Stinson R.M.
        • Lynn J.
        • Barker K.
        • Hildreth J.
        Comparison of instructional methods for screening, brief intervention, and referral to treatment for substance use education in nursing education.
        Nurse Educator. 2018; 43: 123-127
        • Koetting C.
        • Freed P.
        Educating undergraduate psychiatric mental health nursing students in screening, brief intervention, referral to treatment (SBIRT): Using online, interactive simulation.
        Archives of Psychiatric Nursing. 2017; 31: 241-247
        • Lewis L.F.
        • Jarvis L.
        Undergraduate nursing students' experiences and attitudes towards working with patients with opioid use disorder in the clinical setting: A qualitative content analysis.
        Nurse Education Today. 2019; 73: 17-22
        • Mahmoud K.F.
        • Lindsay D.
        • Scolieri B.B.
        • Hagle H.
        • Puskar K.R.
        • Mitchell A.M.
        Changing BSN students’ stigma toward patients who use alcohol and opioids through screening, brief intervention, and referral to treatment (SBIRT) education and training.
        Journal of the American Psychiatric Nurses Association. 2018; 24: 510-521
        • Marshall B.D.
        • Milloy M.J.
        • Wood E.
        • Montaner J.S.
        • Kerr T.
        Reduction in overdose mortality after the opening of North America’s first medically supervised safer injecting facility: A retrospective population-based study.
        Lancet. 2011; 377: 1429-1437
        • McLellan A.T.
        • Lewis D.C.
        • O'Brien C.P.
        • Kleber H.D.
        Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation.
        Journal of the American Medical Association. 2000; 284: 1689-1695
        • Miller N.S.
        • Sheppard L.M.
        • Colenda C.C.
        • Magen J.
        Why physicians are unprepared to treat patient who have alcohol- and drug-related disorders.
        Academic Medicine. 2001; 76: 410-418
        • Moore J.
        • Goodman P.
        • Selway J.
        • Hawkins-Walsh E.
        • Merritt J.
        • Dombrowski J.
        SBIRT education for nurse practitioner students: Integration into an MSN program.
        Journal of Nursing Education. 2017; 56: 725-732
        • Murphy-Parker D.
        Screening, Brief Intervention, and Referral to Treatment: A need for educational reform in nursing.
        Nursing Clinics of North America. 2013; 48: 485-489
        • Nash A.J.
        • Marcus M.T.
        • Cron S.
        • Scamp N.
        • Truitt M.
        • McKenna Z.
        Preparing nursing students to work with patients with alcohol or drug-related problems.
        Journal of Addiction Nursing. 2017; 28: 124-130
        • National Council of State Boards of Nursing
        NCLEX-RN examination: Test plan for the national council licensure examination for registered nurses.
        (Retrieved from)
        • Oermann M.H.
        Integrating substance use content and learning activities in nursing curriculum.
        Nurse Educator. 2018; 43: 109-110
        • Puskar K.
        • Mitchell A.M.
        • Kane I.
        • Hagle H.
        • Talcott K.S.
        Faculty buy-in to teach alcohol and drug use screening.
        Journal of Continuing Education in Nursing. 2014; 45: 403-408
        • Rundio A.
        • Lorman B.
        Core curriculum of addictions nursing.
        3rd ed. Lippincott Williams & Wilkins, Philadelphia2015
        • SAMHSA-HRSA Center for Integrated Health Solutions
        SBIRT: Screening.
        (Retrieved from)
        • Savage C.
        • Dyehouse J.
        • Marcus M.
        Alcohol and health content in nursing baccalaureate degree curricula.
        Journal of Addiction Nursing. 2014; 25: 28-34
        • Savage C.L.
        • Daniels J.
        • Johnson J.A.
        • Kesten K.
        • Finnell D.S.
        • Seale J.P.
        The inclusion of substance use-related content in advanced practice registered nurse curricula.
        Journal of Professional Nursing. 2018; 34: 217-220
        • Smothers Z.
        • Reynolds V.
        • McEacham M.
        • Derouin A.L.
        • Carter B.M.
        • Muzyk A.
        Substance use education in schools of nursing: A systemic review of the literature.
        Nurse Educator. 2018; 43: 136-139
        • Stanton M.
        • McClughen D.C.
        The CDC guideline and its impact on delivering patient-centered care.
        Pain Management Nursing. 2017; 18: 270-272
        • Substance Abuse and Mental Health Services Administration
        Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53).
        Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, MD2018 (Retrieved from)
        • Tilson E.C.
        Adverse childhood experiences (ACEs): An important element of a comprehensive approach to the opioid crisis.
        North Carolina Medical Journal. 2018; 79: 166-169
        • U.S. Preventive Services Task Force
        Final update summary: Alcohol misuse: Screening and behavioral counseling interventions in primary care. Published final recommendations.
        (Retrieved from)
        • Volkow N.D.
        • McLellan A.T.
        Opioid abuse in chronic pain—misconceptions and mitigation strategies.
        New England Journal of Medicine. 2016; 374: 1253-1263
        • Watt-Watson J.
        • McGillon M.
        • Hunter J.
        • Choiniere M.
        • Clark A.J.
        • Dewar A.
        • Johnston C.
        • Lynch M.
        • Morley-Forster P.
        • Moulin D.
        A survey of prelicensure pain curricula in health science faculties in Canadian universities.
        Journal of Pain Research and Management. 2009; 14: 439-444