The Case For Confronting Long-Term Opioid Use As A Hospital-Acquired Condition

The first principle of medicine is to “do no harm.” Over the past two decades, the medical community has attempted to honor this principle by treating patient pain with opioid prescriptions. Unfortunately, these good intentions have driven an epidemic of opioid addiction and drug overdoses, now the leading cause of accidental death in the United States. Inpatient overprescription of opioids such as morphine, oxycodone, and hydrocodone happens in a variety of ways—doctors prescribe too many doses, too large a dose, or allow patients to continue opioid treatment for too long. And many times, doctors could avoid opioid overprescription by setting realistic pain management expectations or by considering alternative analgesics or non-pharmacologic approaches. Prolonged narcotic usage that stems from these clinical decisions could properly be termed a hospital-acquired condition and should be considered a question of patient safety, instead of the result of moral weakness among patients. The policies of both the Joint Commission, in referencing pain as the “fifth vital sign,” and the Centers for Medicare and Medicaid Services (CMS), in using pain control as a barometer of patient satisfaction, have helped normalize the practice of excessive opioid prescribing. The pharmaceutical industry has also contributed to the problem by blocking efforts to curtail opioid prescription. The medical community has only recently started to accept that there is a link between the epid...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Featured Health Professionals Hospitals Population Health hospital-acquired condition opioid epidemic overprescribing opioids pain management Source Type: blogs