The opioid crisis in America remains a serious and ongoing public health concern, with opioid-related overdose deaths continuing to affect individuals and communities nationwide. Everyone has heard about the opioid crisis in America, including the causes, possible solutions, big pharma’s role, and the healthcare policies that either hinder progress or provide hope for the future.
The online Master of Science in Nursing – Family Nurse Practitioner program from Northern Kentucky University (NKU) prepares nurse practitioners to help address complex public health challenges like the opioid crisis through advanced clinical training and patient-centered care. Family nurse practitioners are uniquely positioned to expand access to treatment, support prevention efforts and provide long-term care for individuals with opioid use disorder (OUD), reinforcing their vital role in improving outcomes across diverse patient populations.
What Is an Opioid?
Opioids are substances that include both naturally derived compounds from the opium poppy and fully synthetic analogs created in laboratories. Opiates specifically refer to drugs derived directly from the plant, while “opioids” is now the broader term used for both natural and synthetic forms.
Regardless of their origin, opioids are powerful pain-relieving medications that carry a high risk of addiction due to the euphoria they can produce and their effects on reducing anxiety and discomfort. Their potency and potential for misuse make them central to discussions of public health and the ongoing opioid crisis.
From Prescription to Addiction
Opioids are often prescribed to patients experiencing significant pain from an injury, surgery or chronic medical condition. Overprescribing and prolonged use can lead to iatrogenic, or doctor-caused, opioid use disorder (OUD), with some patients turning to illicit and less regulated forms of the drug, such as heroin, when prescriptions run out or become unaffordable.
Opioid addiction is particularly insidious because individuals often continue taking the medication to avoid opioid withdrawal. Symptoms can include anxiety, irritability, runny nose, muscle aches, hot and cold sweats, vomiting and diarrhea. Once individuals become physically dependent, their use of opioids is no longer primarily to achieve euphoria, but rather to prevent the uncomfortable and sometimes dangerous symptoms of withdrawal, which reinforces the cycle of dependence. Recovery is also challenging, with research from Harvard Medical School indicating that it can take the typical person with opioid use disorder eight years and four to five treatment attempts to achieve even one year of remission, highlighting the persistence and complexity of this public health crisis.
The Economics of Addiction
Both legal and illicit drugs generate significant profits. Pharmaceutical companies, doctors, pharmacies and drug dealers all benefit financially, often at the expense of vulnerable populations, including individuals who have lost jobs due to outsourcing, those with work-related disabilities or people raised in cycles of poverty.
For example, a miner is injured at work and must see a doctor for chronic pain. While he recovers from his injury, the mine shuts down and he loses his job. The doctor has overprescribed, and the ex-miner sells his extra pills to make ends meet, creating a situation where financial incentives contribute to continued opioid use.
Shared Accountability
Parents, families and the individuals struggling with addiction also bear some responsibility. The stigma of having an addicted family member can often isolate the family and keep them from seeking treatment. The same stigma can prevent addicts from talking about their problem before it’s too late. No one wants to be judged.
The solution is to take away the stigma so more people will seek help earlier. Those seeking treatment for themselves or loved ones will also find out they are not alone in this struggle. Not only can others provide emotional support, but they can also share information.
Deaths From Overdose Are Preventable
The opioid epidemic has resulted in tens of thousands of deaths each year, highlighting the devastating impact on individuals and communities nationwide. The saddest part of this story is that many of these deaths are preventable. The anti-overdose drug naloxone, NARCAN, is an opioid antagonist; it binds to the opioid receptors in the brain and reverses and blocks the effects of opioids. It can restore breathing in an overdose victim, preventing death. Some states allow friends and family members of opioid-dependent loved ones to buy naloxone at pharmacies without a doctor’s prescription, while other states require a prescription. The problem is obvious: there is no time to go see a doctor in the middle of an overdose. A policy shift is necessary to allow anyone to buy naloxone at any time.
Additional measures are being implemented to help address the crisis:
- Educating healthcare providers
- Educating policymakers
- Educating the public
- Educating law enforcement
- Increasing access to treatment
- Allowing nurse practitioners to work at the full scope of practice
- Reducing the stigma attached to addiction
Medication-Assisted Treatment
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Medication-Assisted Treatment (MAT) is “the use of medications with counseling and behavioral therapies to treat substance use disorders and prevent opioid overdose.” The following medications are used for treatment of opioid dependence:
Buprenorphine: This medication reduces cravings for opioids while the active addict attempts to get clean. According to SAMHSA, “Buprenorphine is an opioid partial agonist. This means that, like opioids, it produces effects such as euphoria or respiratory depression.” The most crucial effect of this medication may be its ability to prevent dopesickness.
There are a number of FDA-approved medications containing both naloxone and buprenorphine. These medications prevent withdrawal symptoms, but have a nominal amount of the intoxicating effects caused by opioids:
- Bunavail
- Suboxone
- Zubsolv
This sounds like a great option, and it is, but there are restrictions. Physicians can treat up to 30 patients after being authorized under the Drug Addiction Treatment Act 2000. To treat more than 30 and up to 100 patients, doctors can apply to SAMHSA. They must also complete an online form to increase the patient limit after one year. After another year, they can apply to treat up to 275 patients.
Until 2016, nurse practitioners and physician assistants did not have prescribing privileges for buprenorphine. Now they follow roughly the same guidelines as physicians to prescribe buprenorphine.
On the other hand, anyone licensed to prescribe medication can prescribe OxyContin or other prescription opioids. Some states do require a substance-abuse-disorder assessment before the doctor can prescribe an opioid, though these assessments are sometimes nothing more than self-reported questionnaires.
Naltrexone: This medication blocks the receptors to which opioids and alcohol bind. The drug is reported to decrease opioid cravings as well. There are no restrictions for licensed providers to prescribe naltrexone.
Where Do Nurse Practitioners Come In?
Nurses see more patients on a daily basis than any other healthcare providers, which is why it’s so important for them to be well informed about the current opioid crisis. Nurse practitioners have the knowledge to be proactive on all fronts, and the tools to help are well within their scope of practice.
NKU offers two online MSN-Nurse Practitioner programs to prepare nurses with the education they need to help curb the opioid epidemic: The MSN-Family Nurse Practitioner program and the MSN-Psych-Mental Health Nurse Practitioner program.
Courses such as Health Care Policy and Economics in Population Health and Advanced Clinical Pharmacology and Intervention for APRNs provide nurse practitioners with essential knowledge of healthcare systems, policies and pharmacological management. These courses equip nurses to assess, educate and manage patients effectively while understanding the broader social, economic and regulatory factors that influence care.
With the right knowledge and education, nurse practitioners are uniquely positioned to lead efforts in addressing the opioid epidemic. Northern Kentucky University offers programs that provide the clinical skills, policy insight and patient-centered expertise necessary to make a meaningful impact in their communities.
Learn more about NKU’s online MSN-FNP program.
