While opioid drugs play an important role in pain management, an alarming increase in opioid diversion, opioid use disorder, and opioid-related mortality and morbidity in recent years has created a healthcare crisis in the United States. As a primary point of contact for patients receiving anesthesia, procedural sedation, and pain management services, Certified Registered Nurse Anesthetists (CRNAs) are answering the Surgeon General's call to end the opioid crisis with a more holistic approach to pain management designed to reduce dependence on prescription medications and offering patients greater transparency, understanding and engagement in their own care. These and other aspects of the opioid crisis will be discussed at the American Association of Nurse Anesthetists (AANA) Mid-Year Assembly, April 5-9, in Washington, D.C.
Following are key points of information about the opioid crisis:
- CRNAs are anesthesia and pain experts who have been providing healthcare to patients in the United States for more than 150 years. CRNAs are among the many healthcare specialists in the United States who are striving for ways to provide patients with safe, effective and empathetic anesthesia and pain management that isn't drug dependent.
- Opioids are substances that act on opioid receptors to produce morphine-like effects. Medically, opioids are most commonly used to relieve pain. They are, however, highly addictive and are widely sought after on the secondary market by people with dependencies. Many people develop a dependency following a medical procedure.
- Nearly 2 million people in America suffer from prescription opioid use disorder. In addition, half of all opioid overdose deaths involve a prescription opioid, according to the Centers for Disease Control.
- There's a holistic approach to pain management available. Nurse anesthetists are well positioned as members of the interdisciplinary team to provide holistic, multimodal pain management for patients of all ages, across the continuum of pain, in all clinical settings (e.g., hospitals, ambulatory surgical centers, offices and pain management clinics), and in the home. Acute and chronic pain are best treated and managed by CRNAs and an interdisciplinary team of healthcare professionals that actively engages the patient in the diagnosis and management of his or her pain for improved well-being, functionality, and quality of life.
- Carfentanil is the latest threat in the opioid crisis. Carfentanil is a synthetic opioid used to tranquilize large mammals. Carfentanil is easily disguised in heroin or cocaine and is 100 times more potent than fentanyl, further raising the risk of overdose. Healthcare providers, first responders, and others are at risk of accidental exposure to Carfentanil when providing care to an overdose victim in the emergency room, operating room, obstetric department, or at the scene of an accident or crime.
- Enhanced Recovery After Surgery (ERAS) encourages decreased use of opioids. CRNAs integrate multimodal pain management as an element of ERAS protocols to manage pain. Management occurs from pre-procedure to post discharge using opioid limiting techniques. An increase in painkiller prescribing is a driver of the increase in prescription overdoses.