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Myth of opioid
This document discusses myths and facts about opioid use and pain management in elders. It addresses that less than 1% of those taking opioids for pain become addicted, and that opioids are an effective treatment for severe pain. It also notes that unrelieved pain can compromise the immune system, and that communication is key to good pain management. Barriers to pain management include personal biases, knowledge deficits, and fears of addiction or side effects. Proper assessment using tools like the WHO ladder and non-pharmacological interventions are important for comprehensive pain treatment.
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Myth of opioid
- 1.
- 2. Fact or Myth Peoplewho take pain medication (opioids) generally become addicted.
- 3. MYTH Less then 1percent of those who take opioids for pain become addicted.
- 4. Fact or Myth Elderstend to report more pain as they age.
- 5. MYTH Many elders tendto not report their pain because they think it is a natural part of growing older.
- 6. Fact or Myth Opioidsshould not be considered when treating elders with severe pain.
- 7. MYTH Opioids are thefirst line of defense we have to combat severe pain. Opioids have no maximum daily dose.This allows us to adjust dose to effective level, no matter how severe.
- 8. Fact or Myth Effectivepain control improves the ability to fight disease.
- 9. FACT One side effectof unrelieved pain is a compromised immune system.
- 10. Fact or Myth Constipationis a manageable side effect of opioid use.
- 11. A bowel programmust always be initiated with opioid use. FACT
- 12. True or False Communicationis a key component in good pain management.
- 13. Communication must occur betweenall persons/departments. TRUE
- 14. Name three reasonswhy families or caregivers may not recognize or believe elders’ reports of pain.
- 15. • Fear ofaddiction • Culture • Fear of side effects • Don’t want loved one to be “targeted or labeled” • Knowledge deficit
- 16. Name three barriersto good pain management by health care providers.
- 17. • Personal biases •Inadequate pain assessment skills • Lack of knowledge • Lack of time • Fear of patient addiction
- 18. Name three barriersto good pain management by physicians.
- 19. • Fear oflegal issues • Fear of regulatory scrutiny • Unfamiliarity with opioids • Fear of patient addiction • Concern about detrimental side effects • Lack of communication by health care personnel and the patient/family
- 20. Give three reasonselders may not report pain.
- 21. • Worry aboutcost • Fear of addiction • Fear of losing independence • Don’t want to be a bother • Culture • Fear of side effects • Cognitively Impaired • Depression • Low expectations for pain relief
- 22. True or False Aperson’s pain is whatever they say it is and exists whenever they say it does.
- 23. This is thedefinition advocated by Margo McCaffery and is subscribed to by many pain management programs. TRUE
- 24. Give three signsof pain that might be exhibited by cognitively impaired elders.
- 25. Changes inemotion (tears) Changes in movement (restlessness) Verbal cues (whimpering, screaming) Facial cues (grimacing) Changes in body position (guarding)
- 26.
- 27. Words to describepain Intensity of the pain Location of the pain Duration of pain Aggravating/Alleviating factors
- 28. What words mighta person use to describe Neuropathic pain?
- 29. • Shooting • Stabbing •Burning • Tingling • Numbness • Radiating
- 30. What words mighta person use to describe Somatic and/orVisceral pain?
- 31. Somatic – aching,throbbing, gnawing Viceral – cramping, pressure, deep aching, referred
- 32. True or False Painmedication can not be administered to a person unless they ask for it.
- 33. Staff and familyshould recognize signs/symptoms of pain in individuals and speak on their behalf. FALSE
- 34. True or False Nursingis the only discipline that needs to be educated on pain.
- 35. All health careworkers are part of the team responsible for providing effective pain management. FALSE
- 36. Name three differentnon- pharmacological interventions.
- 37. Massage Heat/Cold Relaxation/ Imagery Distraction Pastoral Consult Exercise Immobilization TENS (transcutaneous electrical nerve stimulation) Acupuncture Hypnosis
- 38. How often shouldthe nurse complete a comprehensive pain assessment?
- 39. Admission/Readmission Changein pain status or health status Each Minimum Data Set/ Outcome and Assessment Information Set (MDS/OASIS) Assessment
- 40. Name three thingsto educate the elder and family about when implementing opioids or pain management.
- 41. Benefits ofeffective pain management Options available Goal of treatment Side Effects and their treatment (bowels!) Cost Negative effects of pain Pain symptoms – including nonverbal
- 42. True or False Theelderly usually have at least three different sites of pain.
- 43. And it isimportant to assess each pain site separately and document according to WILDA criteria. TRUE
- 44. List at leastthree differences between acute and chronic pain.
- 45. Acute Pain Short term Sudden onset Usually known cause Usually goes away Typically doesn’t cause severe emotional stress Chronic Pain Often unknown cause/onset Causes depression, sadness, anxiety, anger, loss of control May continue throughout life and requires comprehensive treatment
- 46. What are somenon- pharmacological interventions that the departments other than nursing can do?
- 47. Involve inactivities 1:1 room visits Aromatherapy Touch – massage, lotion Take on walks Read Support groups
- 48. What can administrationdo to support effective pain management?
- 49. Effective policies Adequate supplies Training/education programs
- 50. What does theWHOLadder stand for and how is it used?
- 51. World HealthOrganization ▪ Systematic approach to treat mild, moderate and severe pain
- 52. Jeopardy Game Templateadapted from the work of Susan Collins and Eleanor Savko, District Resource Teachers for Hardin County Schools: www.hardin.k12.ky.us/res_techn/sbjarea/math/MathJeopardy.htm This material was prepared by the New Mexico Medical Review Association (NMMRA), the Medicare Quality Improvement Organization for New Mexico, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. It is based on material produced by the Kansas Foundation for Medical Care. The contents presented do not necessarily reflect CMS policy. 9SOW-NM-PS-08-36
- 53. 200 pt 300 pt 400pt 500 pt 100 pt 200 pt 300 pt 400 pt 500 pt 100 pt 200 pt 300 pt 400 pt 500 pt 100 pt 200 pt 300 pt 400 pt 500 pt 100 pt 200 pt 300 pt 400 pt 500 pt 100 pt Fact/Myth Barriers Assessment Education Interventions