FDA now requires 'black box' warning on IR opioids

[Graduatenurse14]

I'm not sure where to put this.

FDA announces enhanced warnings for immediate-release opioid pain medications related to risks of misuse, abuse, addiction, overdose and death

What can we at the bedside do to help prevent a patient from getting addicted? Does it even start at the bedside? I'm not talking about patients who already have addiction issues but those who are opioid- naive when the get admitted with pain and/or post-op pain.

Most of the time my post-op patients are given a script for #30 of whatever was working for them at the hospital (Ex. Norco, percocet) should I say more or say differently anything about not taking the pain meds when they are no longer needed? What do you say? Does your hospital have a script/policy for you? Mine doesn't. Should they? Should we just leave it up to the Pharmacist?

According to the CNN article, Pharmacists encouraged to give people information about opioids (Both IR and ER.) Do you know, is it more than all of that paper that is stapled to the bag? Is it a separate paper or booklet? I've never had to get one filled I just give them out at work.

FDA now requires 'black box' warning on opioids - CNN.com

[nutella, MSN, RN]

I just got an email the other day to alert me that the law in MA has changed and initial prescription for narcotics will be limited to a 7 day supply to prevent over prescribing.

Also, there is a monitoring program so that people with addiction do not have as easy access :

http://www.massmed.org/physicians/practice-management/practice-ownership-and-operations/state-faqs-on-prescription-monitoring-program-%28pdf%29/

Having said all of it, I personally believe that a person has to have the drive for addiction to become easily addicted - though any person become addicted. And there is a difference between addiction because a person takes medication not for tx but for the other effects (euphoria, sedation, etc) and "addiction" - or better tolerance - when for example a cancer patient takes narcotics daily to deal with that pain.

You can educate your patient about the potential for addiction, the need to take bowel medications in addition, and the need to go back to the MD if pain persists.

[KatieMI, BSN, MSN, RN]

Answering your question, pharmacists are also grilled hard about "customer satisfaction". So, everything they can say is "doyouhaveanyquestions? Please go to the website listed right here if you want to learn more".

There is no flyer, label or anything else attached to the filled pack, only standard huge list of everything, which is typically ripped off and goes into trash bin right away. And it is completely up to patient to "want to learn more" or not.

I am not sure if nurses can change anything about teaching comparing with what is done already. We tell people that these drugs CAN cause addiction. 99.99% of patients understand it like "they can, but I am in pain, and it will not be me, so why the heck should I care?" 7 days limit will help, if only the monitoring systems will block any further prescriptions obtained from "alternative sources" like urgent care or ERs. At least in Michigan, it is not so.

IMHO, one thing that would really help is defining indications for opioids and following them as strictly as for everything else. I cannot go to my PCP and get a script for, say, thyroxine simply because I want to have it. Same rule should be for opioids for acute low back pain, fibromyalgia and osteoarthritis.