Opioid addiction in global nations such as the US is considered as one of the modern-day public health problems that causes not only health but also economic as well as social problems. Opioids can be termed as a class of drugs that tend to act on the opioid receptors consequently, producing morphine like effects. Examples of common opioid include hydrocodone, Codeine, oxycodone, tramadol, fentanyl, and hydromorphone (US national Library of Medicine).
Due to opioid’s ability to act on the nervous system thereby producing or rather stimulating feelings of pleasure while also releasing pain, this class of drugs is usually legally prescribed by various healthcare professionals/providers to manage severe as well as chronic pain among patients such as in cancers patients (US national Library of Medicine). Despite their benefits, modern day rise in opioid related to abuse, misuse, overdose cases, mortality and morbidity has greatly reignited scrutiny; thus in prescription practices by not only state medical boards and regulatory agencies but also among law enforcement, and the general public (Melemis). Therefore, although opioids are considered as an important tool for health professionals such as physicians in treating/reliving pain, these prescribed opioid medications carry significant risks if misused by patients or rather prescribed inappropriately by healthcare professionals, this paper therefore argues on the need for mandatory opioid training for healthcare professionals such as doctors and physicians.
Arguments against Mandatory Opioid Training
Decrease in the Number of Physicians willing to Prescribe Opioids
Perhaps one of the major arguments against mandatory opioid training as highlighted by various major organizations that highly oppose this motions including the “American Medical Association” as well as the “American Academy of Family Physicians” is the fact that it place a significant burden on physicians. Consequently, the opponents argue that this will in, turn, decrease the overall number of physicians that are willing enough to prescribe opioid drugs for patient with chronic pain. They further argue that implementing mandatory opioid training will consequently make it extremely difficult; thus for patients these pain relieving opioids.
Counter argument-Although this argument might be somewhat true
Counter argument-Although this argument might be somewhat true, research studies on the topic have indicated otherwise. Concerning this, supporting the effectiveness of opioid training programs include studies by O’Rorke et al, which found that physicians as well as health care providers that were most comfortable and more w confident in prescribing opioids and management patients’ chronic pain were those that received training on opioids after residency (O’Rorke, 100). Moreover, research by Jamison, et al., further indicates a general concern as well as reluctance of health professionals especially primary care physicians to participate in or manage the prescription of these opioids drugs. In the study, as compared to older healthcare providers, young providers expressed more reluctance and concerns about opioids. Concerning this, since many healthcare providers report low satisfaction levels as well as inadequacy of their formal training in medical schools with regard to the prescription of opioids, establishing mandatory opioid training for the health care providers in an effort to increase knowledge in this area to a great extent will increase the number of healthcare professional willing to prescribe these drugs due (Jamison, et al., 380).
Counter argument-In addition, while the argument by the opponents of mandatory opioid training that this motion will make it extremely difficult for patients to access these opioid drugs, research indicates that this will only occur to patients who abuse the opioids drugs. This is due to the fact that mandatory training is effective in enabling health care practitioners to identify all the opioid patients that are at risk of opioid misuse (Pearson, 134).
Increased Burden
Several experts opposing the implementation of mandatory opioid training for doctors argue that this strategy will ultimately burden prescribers with what they termed as too much additional work. According to experts, doctors are already facing what can be termed as significant with Electronic Medical Records burdens (Loiaconi).
Counter argument- Ultimately, the implementation of mandatory opioid training will burden many doctors, however, patient safety and welfare is more important and it is the primary role of healthcare professionals to promote/ensure their patient’s welfare. Moreover, this strategy to a great extent will do “more good than harm” as it will aid in dealing with the opioid epidemic by reducing the number of opioid related overdose deaths.
Arguments for Mandatory Opioid Training
Rise in Opioid Deaths and Existence of knowledge Gaps in Opioid Prescription
In accordance to the Center for Disease Control and Prevention Centre, approximately 200,000 individuals have died from opioid related deaths between 1999 and 2016. Research further indicates that as compared to 1999, in 2016, overdose deaths; thus from prescription opioid were five times higher (Centre for Disease Control and Prevention). Concerning this, in 2016 more than 63, 632 drug overdose deaths were recorded in the US, however, both prescription and illicit opioid use was the key driver of the drug overdose deaths. As a result, opioid-related accounted for 66.4% of the total drug overdose deaths which translates to about 42, 249 deaths (Centre for Disease Control and Prevention).
Therefore, one of the arguments supporting mandatory opioid training for all doctors is due to the rise in opioid abuse, and overdose deaths as result of existence of knowledge gaps among healthcare professionals in the prescription of opioids. In relation to this, some of the factors implicated by research studies in the opioid problem include inefficient prescribing and improper use of opioid as well as lack of adequate knowledge among physicians with regard to interpretation and assessment of the patient’s pain levels (Jukiewicz, et al., 430). Furthermore, research indicates that although most opioids are prescribed by specialists, a high percentage of these healthcare professionals report inadequate training in not only opioid prescription but also chronic pain management. Such is a study by Pearson et al, which using a KnowPain-50 survey, most of the healthcare physicians scored significantly lower; thus on all questions involving opioids. Moreover, another study on the Family Medicine Physicians from West Virginia also showed similar results where the respondents only scored 60% on six out of a total of 10 questions on opioid prescription (Pearson, 131).
Given that more than 27% of the opioid abusers obtain these drugs directly by prescription from physicians as well as the fact that opioid related overdoses account for 66.4% of all drug overdose deaths, prescribing practices have a crucial role thus in reducing both the availability of these drugs for misuse as well as in reducing opioid-overdose related deaths (Dineen " DuBois). Generally, physicians have a responsibility of conscientious and carefully prescribing opioids which also includes conducting patient assessment, communication, as well as conducting patient education. In practice, this responsibility will to a great extent be heightened if mandatory opioid training was instituted as it will advance their knowledge on the topic.
Therefore, instituting mandatory training will aid in guiding healthcare professionals when prescribing these drugs. Furthermore, it will also reduce the existing knowledge gaps with regard opioid prescription and that exists due to presence of voluntary opioid training programs, which will aid in reducing the rising cases of opioid abuse, overdose, and deaths.
Effectiveness of Opioid Training Program and Failure of Current “Voluntary” Opioid Training Programs
Generally, low scores on clinically based questions; thus on opioid is a clear indication of the need and the opportunity to provide what can be termed as focused educational content; thus in this area of practice. Moreover, these low scores are also an indication of the lack of interest in the voluntary opioid training programs, therefore to a great extent, these voluntary programs have failed in ensuring that health care providers have adequate knowledge in the use and prescription of opioids and remain updated on the topic (Pearson, 131).
While there have been a few studies that have applied focused objective tools in order to evaluate the providers’ knowledge on opioids; thus both before and after receiving training or rather educational intervention in this area, a significant number of research studies have discovered/acknowledged that existing knowledge gaps tend to be amenable to provider training/education (Pearson, 134). Concerning this, according to a study conducted by Lalonde et al. increased hours of opioid training programs were highly associated with greater scores; thus in the KnowPain-50. The effectiveness of opioid training is further supported by a longitudinal study in which health care practitioners received education/training and a one year follow up reported major improvements, whereby, the health practitioners felt more sufficiently trained in not only the management but also the prescription of opioids. The study also concluded that opioid training is also effective in enabling health care practitioners to identify all the opioid patients that are at risk of opioid misuse (Pearson, 134).
Therefore given the fact that opioids training programs are very effective and also the fact that most health care professionals fail to take interest in the voluntary programs currently provided, opioid training programs should be made mandatory so as deal with the opioid epidemic. This is important as opioid prescription training will allow all medical personnel to not only assesses risks of potential patient abuse or rather addiction of prescription opioids but also provide highly individualized care to different patients with chronic pain.
Need to Incorporate Latest Scientific Evidence on Opioids Prescription, Abuse, and Use.
Conclusively, another argument supporting the institution of mandatory opioid training is based on the fact that in the contemporary, world, most doctors; especially those that have never participated in the voluntary opioids training programs, base their overall prescription of opioids on what can be termed as out-of-date views on both opioid dosing and tolerance that they learnt decades ago while in medical school (Fitzgerald, 45). Therefore, this paper supports the recommendation put forward by the advisory panel of the US “Food and Drug Administration (FDA)” to implement mandatory opioid training for physicians among other health care professionals. This is due to the fact that such as measure will ensure that all medical practitioners are receive updated information on the topic.
Further, there is also need for information on opioid use to be based primarily on latest scientific evidence on the topic; hence, a mandatory program will create awareness among health care professionals on evidence-based practices in the practice based on recent scientific research (Fitzgerald, 45). Mandatory opioid training is also advantageous as it will also stimulate people’s interest on the topic consequently stimulating important questions that require further future scientific research which will in, turn, aid in coming up with possible solutions to the opioid problems.
Conclusion
In conclusion, this paper therefore argues on the need for mandatory opioid training for healthcare professionals such as doctors and physicians. Some of the arguments supporting the implementation of mandatory training programs include the fact that there great need to incorporate latest scientific evidence on opioids prescription, abuse, and use which can only happen through mandatory training. Another reason is that while research has shown the effectiveness of opioid training programs, failure of the current “voluntary” opioid training programs ultimately calls for mandatory programs so as to take full advantage of the benefits associated with opioid training programs. Furthermore, rise in opioid overdose cases which has been associated with existence of knowledge gaps to a great extent calls for mandatory training to increase knowledge among health professionals.
Works Cited
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