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A Framework for the Treatment of Pain and Addiction in the Emergency Department

2014; Elsevier BV; Volume: 40; Issue: 6 Linguagem: Inglês

10.1016/j.jen.2013.12.020

1527-2966

Maureen A. Allen, Heather Jewers, Jane S. McDonald,

Pain Management and Opioid Use

Painful conditions account for over 70% of all ED visits in the United States and Canada, yet research has found that pain management for both acute and chronic pain is often inadequate and opioid analgesics are often underused or inappropriately prescribed. 1 Centers for Disease Control and Prevention Ambulatory health care data. http://www.cdc.gov/nchs/ahcd.htm Google Scholar , 2 Fischer B Argento E Prescription opioid related misuse, harms, diversion and interventions in Canada: a review. Pain Physician. 2012; 15: ES191-ES203 PubMed Google Scholar , 3 Lynch M The need for a Canadian pain strategy. Pain Res Manag. 2011; 16: 77-80 PubMed Google Scholar The use of prescription opioid analgesics to treat acute and chronic pain has substantially increased in North America in the past decade and so has the incidence of misuse, related harm, and diversion. 2 Fischer B Argento E Prescription opioid related misuse, harms, diversion and interventions in Canada: a review. Pain Physician. 2012; 15: ES191-ES203 PubMed Google Scholar , 4 National Advisory Committee on Prescription Drug Misuse First Do No Harm: Responding to Canada’s Prescription Drug Crisis. Canadian Centre on Substance Abuse, Ottawa2013 Google Scholar , 5 International Narcotics Control Board Canadian Centre on Substance Abuse. Prescription drug misuse. http://www.ccsa.ca/Eng/Priorities/Prescription-Drug-Misuse/Pages/default.aspx Google Scholar It is surprising therefore that very little education and training are offered to emergency care personnel on pain management and how to best deal with the risk of addiction, diversion, and abuse associated with dispensing controlled substances. Maureen A. Allen is Chronic Pain and Palliative Care Consultant, St Martha’s Regional Hospital, Antigonish, Canada. Heather Jewers is Assistant Professor of Nursing, St. Francis Xavier University, School of Nursing, Antigonish, Canada. Jane S. McDonald is Emergency Department Nurse, Kaiser Medical Team, Kaiser Permanente San Rafael Medical Center, San Rafael, CA.