You’ve heard the alarming statistics: The CDC reports that on an average day, 130 Americans die from an opioid overdose. In 2017, the number of overdose deaths involving opioids was six times higher than in 1999.[1] In fact, today, accidental drug overdoses are the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids.[2]
It’s a crisis of addiction that is destroying our young people and their families. Some of the myriad causes of the opioid epidemic include corporate greed, provider over prescription, a healthcare system that makes it easy to accumulate doctors, a legal system that criminalizes drug users, and entrenched poverty.
The Opioid Crisis and the Role of an EdD
In the healthcare community, there is a push to further educate practitioners, especially physicians and nurses, about how they can respond to the opioid crisis. If you’re a healthcare practitioner with a Doctor of Education (EdD) degree, what is your role? What strategies can you teach other practitioners so they can help prevent addiction—and save patient lives?
Educating practitioners about strategies to help combat addiction
Start with Your Specialty
Many healthcare practitioners earn their EdD so they can prepare to teach the next generation of practitioners in their field. With their EdD, healthcare clinicians can serve an important role in teaching their colleagues about combating opioid addiction. Given that nurses teach nurses, physical therapists teach physical therapists, etc., the following are strategies that EdD educators can use when teaching their colleagues about the opioid epidemic.
Nurses
Nurses are on the front lines of the opioid epidemic, caring for populations that are the most at-risk. If you are a nurse teaching other nurses about opioid abuse, you can:
- Teach nursing students the CDC’s recommended opioid prescriber practices. The CDC emphasizes that, except in palliative and cancer care, opioids are not first-line therapy and that non-pharmacologic and non-opioid pharmacologic therapies are preferred. When opioids are started, the lowest effective dose is recommended, as well as immediate-release pills and a short prescription duration (in the case of acute pain).[3]
- Explain that while nurse practitioners can prescribe opioids, all nurses are equipped to assess a patient’s pain and need for pharmacologic pain relief. All nurses should be observant of whether physicians and other prescribers in their organization could be over prescribing. Prescribers should consult the state’s prescription drug monitoring program (PDMP) to get information on the patient’s prescription history.
- Educate nurses about the use of naloxone, a life-saving medication that rapidly blocks the effects of opioids when signs and symptoms of an opioid (including heroin and fentanyl) overdose first appear.
- Educate nurses about the role of medication-assisted treatments, including buprenorphine, naxolone, Saboxone® and methadone. These treatments are more effective when combined with a form of behavioral treatment. They have been shown to be more effective than abstinence-based treatments.[4]
- Point nursing students toward further educational resources.[5]
Athletic Trainers
If you’re teaching athletic trainers, they should know that:
- Due to the higher risk of injury, athletes are at a greater risk for non-medical prescription opioid use than the general public.
- Athletes are under pressure to maintain a high level of performance, balance academics with sports, and cope with the threat of career termination. These physical and mental stressors may spur athletes to misuse and abuse pain medication.
- Athletes are less likely to admit to opioid misuse or abuse due to consequences from coaches or parents.
- College-level athletes and athletes with a history of mental health problems are more likely to misuse and abuse drugs than other athletes.
- Athletes who participate in high-contact sports have also reported higher opioid use due to the increased likelihood of severe injuries.
- ATs should monitor at-risk athletes to understand their motives for misusing and abusing opioids—whether for pain relief (beyond their allotted dosage) or the sensation of feeling high.
- ATs should be well versed in the signs and symptoms of opioid misuse and abuse so they can help an athlete who may be struggling. They should know how to educate athletes about opioid abuse.[6]
Physical Therapists
If you’re teaching physical therapists, teach them about pain management exercises and therapies. PTs should know that:
- Physical therapy and other non-drug approaches should be seriously considered as a first-line treatment for most types of pain.[7]
- PT is a much better option than painkillers for many conditions, particularly chronic musculoskeletal disorders. In chronic conditions, opioids become less and less effective, with huge risks and side effects.
- PT pain relief treatments include exercises, massage, joint manipulation, dry needling, electrical stimulation, and more.[8]
- PT helps patients do more than mask the pain. It helps them improve or maintain their physical mobility and quality of life.
- Even in situations when opioids are prescribed, the CDC recommends that patients receive the lowest effective dosage, and that opioids be combined with non-opioid therapies, such as physical therapy.[9]
Occupational Therapists
If you’re teaching OT students, you can focus on strategies for helping clients with non-drug approaches to pain management. OTs look at the whole client, considering the sensory, cognitive, and emotional dimensions of chronic pain. You can guide OTs to:
- Help clients redirect negative attitudes toward their pain and develop better coping strategies to manage their pain, so it has less impact on their daily activities.[10]
- Teach clients how to independently and proactively use non-pharmacological pain control modalities, such as heat and cold, safe body mechanics, neuromuscular re-education, and muscle tension reduction.
- Teach clients how to self-regulate their activity levels, adapt their activities to avoid pain, maintain a home exercise program, and cultivate a daily relaxation or meditation practice.[11]
Healthcare Administrators
If you’re teaching healthcare administrators, you can teach them about the role of hospitals and health systems in responding to the crisis. Healthcare organizations should:
- Provide education for all clinicians on prescribing practices, opioid abuse screening tools, and medication-assisted treatment options.
- Educate clinicians, patients, families, and caregivers about non-opioid pain management techniques.
- Educate clinicians about how to address the stigma around addiction that can prevent patients from seeking help.
- Collaborate with community groups, such as opioid treatment programs, addictions counseling organizations, and community mental health centers, as well as local health departments, law enforcement, schools, and political leaders.[12]
Make a Difference
With a Doctor of Education degree that focuses on health sciences, you are well-positioned to educate the next generation of practitioners. In this role, you can make a positive difference in combating the opioid epidemic and beyond.
The University of St. Augustine for Health Sciences (USAHS) offers an online EdD program designed for working clinicians and healthcare educators, with optional on-campus immersions and an optional international trip to study global health systems. Specializations include Nursing Education, Athletic Training, Teaching and Learning, and Executive Leadership. Complete coursework when and where you want and earn your advanced degree while keeping your work and life in balance.
[1] Centers for Disease Control and Prevention, “Understanding the Epidemic”: https://www.cdc.gov/drugoverdose/epidemic/index.html
[2] J Katz, “Drug Deaths in America Are Rising Faster Than Ever,” The New York Times, June 5, 2017.
[3] CDC, “CDC Guideline for Prescribing Opioids for Chronic Pain”: https://www.cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf
[4] American Nurses Epidemic, “The Opioid Epidemic: The Evolving Role of Nursing,” August 2018: https://www.nursingworld.org/~4a4da5/globalassets/practiceandpolicy/work-environment/health–safety/opioid-epidemic/2018-ana-opioid-issue-brief-vfinal-pdf-2018-08-29.pdf
[5] American Association of Colleges of Nursing, “Opioid Epidemic Resources for Nurse Educators”: https://www.aacnnursing.org/Policy-Advocacy/Opioids
[6] Katie Ostrovecky, “Opioid Abuse Series Part 1: An Athletic Trainer’s Role in Preventing Opioid Abuse,” Board of Certification for the Athletic Trainer, February 19, 2018: https://www.bocatc.org/blog/opioid-abuse-series-part-1-an-athletic-trainer-s-role-in-preventing-opioid-abuse
[7] PTinMotion, “Painkiller Abuse to Heroin Addiction: Can Physical Therapy Help Stop It Before It Starts?” August 27, 2015: https://www.apta.org/PTinMotion/News/2015/8/27/OpioidAbusePT/
[8] Libby Mitchell, “Pain Relief Through Physical Therapy,” U Health, University of Utah, Nov 16, 2016: https://healthcare.utah.edu/healthfeed/postings/2016/11/pain_relief.php
[9] American Physical Therapy Association, “Physical Therapy vs Opioids: When to Choose Physical Therapy for Pain Management,” MoveForwardPT: https://www.moveforwardpt.com/resources/detail/physical-therapy-vs-opioids-when-to-choose-physica
[10] Ashley Opp Hofmann, “Living Life to Its Fullest: Managing Chronic Pain with Occupational Therapy,” The American Occupational Therapy Association: https://www.aota.org/About-Occupational-Therapy/Professionals/HW/Articles/Chronic-Pain.aspx
[11] The American Occupational Therapy Association, “Occupational Therapy and Pain Rehabilitation,” https://www.aota.org/About-Occupational-Therapy/Professionals/HW/Pain%20Rehabilitation.aspx
[12] American Hospital Association, “Stem the Tide: Addressing the Opioid Epidemic,” 2017: https://www.aha.org/system/files/2018-06/stem-the-tide-addressing-opioid-epidemic.pdf
