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Addiction education for health care professionals, is it needed?

I have been a nurse for over a decade and I have worked in a variety of settings throughout my career and one thing I have found to be a universal need within our profession is education about addiction, how to handle it whether it be a patient or one of our own and how to prescribe possible needed medication to that individual. I have seen patients walk into doctor's offices, tell the physician they are an alcoholic and then watch a physician turn around and write for a RX for percocet or xanax without batting an eye. Xanax is nothing more than alcohol in pill form. I know what some of you are going to say....Its not the doctors responsibility to keep the alcoholic or addict from drinking or using again, I agree but I also disagree. Some people do not have the education they need related to their disease and YES, drug addiction and alcoholism is a disease. The problem is we in health care do not have the education needed to hook people up with the resources they may need if they do have a problem or know that a woman who comes in and is expressing significant anxiety after her mothers death but has stated she is an alcoholic, do not turn around an give her an RX for xanax which she uses for a couple weeks and then can't figure out why she wants to drink after years of sobriety. We must become more educated about addiction and alcoholism and it's many subtle facets. Alcoholism and drug addiction is killing people including many within our own profession only its dealt with silently. I remember a patient I had in an orthopedic practice I was running who had had a knee replacement that had had a lot of problems post op. We had been giving her narcotics for a number of weeks and she came in one day because she felt like she was losing her mind. The physician looked at her knee, her vitals and did an assessment coming up blank. I knew exactly what was wrong. She had stopped taking her vicodin a couple days prior and was in withdrawl and had no idea. Needless to say neither did the physician. After I explained to her what was happening she said she would never touch another narcotic again not knowing what could occur with long term use due to multiple complications with a surgery. She was not warned or monitored. I talked with the doctor and of coarse he just looked at me with that blank stare and moved on. Which is usually the exact reaction they give when a patient states they are alcoholics or addicts.

What about a situation where you know you have a patient who is med seeking? Or a patient who is getting multiple narcotic medications from multiple doctors? Or a patient who has told you he/she is an addict. Would it be appropriate to give them a benzo for anxiety? Would that put them at risk of relapse? If you knew a patient had a problem, would you know who they could contact for help? We must ask ourselves these questions and really evaluate where patients may be slipping through the cracks.

Leslie


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2 Responses to “Addiction education for health care professionals, is it needed?”

  1. Leslie Says:

    No replies, I find that very interesting. Suddenly nurses who are known to have their own opinion on everything now have none.

  2. Rebecca RN Says:

    Leslie,

    Your first scenario-the woman who is an alcoholic-is she sober now?? Calling Xanax “alcohol in pill form” is just wrong. If her mother passed, she probably was suffering from Anxiety. There is nothing wrong with treating her for it for a short time and monitoring her progress. Did she start drinking again?? If she did-I can guarantee you that is is not because she was prescribed some Xanax.

    As far as the ortho patient-are you insinuating that she is an “Addict” because she had withdraw symptoms? That will happen to anyone who takes an opiate for even a few weeks. Doesn’t mean she is an addict. The physician and her PHARMACIST should have warned her to TAPER off the medication. Because she had withdraw does not an addict make.

    How do you know someone is med-seeking? How do you know someone is doctor shopping? You better have your facts straight before you make such statements….accusing someone of something like that can cause them a world of hurt. Are they a chronic pain patient that has not had their meds adjusted in a long time? Or are they being treated my your run of the mill doc and not a PAIN SPECIALIST? These are the things to consider before making statements like that.

    I think the best thing for your IS to educate YOURSELF. There are many people/patients out there who are suffering in pain because of nurses like you. If you feel like because someone takes a scheduled med they are or will become an addict-there is a problem there….maybe you need to sit down and evaluate where YOUR feelings are coming from. Doctors know what they are doing….in your post you seem to criticize the actions of not one but two physicians.

    So my advice to you is-find an online CEU course in addiction or a cass on it…..then re-evaluate your post. You need to understand that Addiction is a disease-it is a brain disease that can be treated-just like diabetes or high blood pressure. Not everyone who takes a narcotic is going to “catch” it….usually there are factors that predispose individuals to addiction….those are the people who should be monitored. Do some research online, go to chat rooms and such and talk to recovering addicts. You also need to find some compassion for people/patients that may need medication for Anxiety or Chronic Pain…you are lucky if you have never dealt with either….imagine what it would be like if the roles were reversed and you were that patient and there was a nurse treating you like this! I have a lot of experience dealing with TRUE addicts, patients who were UNDER medicated or not medicated with the appropriate drugs. I was accused of stealing my daughters medication when in fact it was someone at her doctors office that was faxing/phoning in scripts….not me. Imagine how that felt….So-like I said educate and reevaluate yourself. It is the best thing that you can do for not only you but for the patients you care for.

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