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Abuse of prescription of narcotics in primary care and its prevention - Dissertation Example

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n the medical world, pain has consistently been categorized into two encompassing variations: firstly, the pain patients experience as a result of malignant cancers; and secondly, chronic pain associated with non-malignant cancers, and other illnesses …
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Abuse of prescription of narcotics in primary care and its prevention
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Abuse of prescription of narcotics in primary care and its prevention

The prescription of opioids to assist the patients with malignant cancers has proven to be beneficial, but the increasing misuse and abuse of these medications by patients suffering from non-chronic pain has served to overshadow the benefits of opioids, despite the wide variety of medications available to treat non-cancer associated pain (Potter et al, 2001). While theoretically, the constant prescription of opioids is necessary and effective only in the treatment of malignant cancer-related, significantly more serious pain (Becker et al, 2011), health practitioners seem to have favored the prescription of these drugs in cases of all chronic pain (Potter et al, 2011). The supposition is therefore that this more widespread prescription has led to NUPM and PUPD. But it is not only the increase in prescription of opioids that can explain the ballooning of the incidence of NUPM. It seems that the failure of health professionals to monitor their patients’ use of drugs may also be a significant factor arguing for restraint, and even the cessation of the practice of widely prescribing opioids (Liebschutz et al, 2010). What are the conditions, consequently, that should accompany the distribution if opioids to patients? Is the only available, effective option to ban these medications outright, or would it be possible to formulate and implement policies that would effectively prevent abuse and misuse of these narcotics? A. Trends in the prescription of narcotics The findings of studies suggested that the varied barriers to the use of opioids must be addressed before any mandates or guidelines regulating the prescription of opioids can be implemented. Primary caregivers are more likely to be frustrated by the barriers, than by conforming to sets of guidelines. Therefore the prescription of opioids for the treatment of chronic pain in older patients is widespread. Spitz et al. (2011) found that the majority of the participants in their quantitative study were prescribing opioids to older patients, but only as a second or subsequent line of treatment. This initial reluctance may be due to the possibility of causing harm; the subjective nature of pain; deficient education regarding the effectiveness and consequences of using opioids; and the stigma attached to opioid use. Family members and the patients themselves were reluctant to try opioid treatment due to concerns regarding possible opioid abuse or misuse. In the findings of other studies, it was clear that significant attention had been given to the probability of substance abuse in patients prescribed opioids on a regular and ongoing basis. The clinical significance of the association between opioid use and common mental disorders is often overlooked. The evident lacunae resulting from the overemphasis on substance abuse, and the underemphasized incidence of mental disorders must be addressed. The prevalence of high-risk patients, in the prescription of opioid treatments, is a vital consideration. Patients on opioid treatment were found to be two to three times more likely to seek mental health assistance by Sullivan et al. (2006) despite their not reporting a higher requirement for substance abuse treatment. In this cross-sectional study, it was found that continued use of opioids in participants, over the period 1988-2001, posed an increased risk for common mental disorders. This study illustrates the link between common mental disorders, as well as substance abuse, with the continuous use of prescribed opioids based on evidence from a large prospective population based data study. Furthermore, a lack of confidence among physicians relating to the prescription of narcotics can be discerned. Nonetheless, urine toxicology screening was rarely carried out either ... Read More
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