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MYTH of OPIOID

Myth of opioid

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Page 1: Myth of opioid

MYTH of OPIOID

Page 2: Myth of opioid

Fact or Myth

People who take pain medication (opioids) generally become

addicted.

Page 3: Myth of opioid

MYTH

Less then 1 percent of those who take opioids for

pain become addicted.

Page 4: Myth of opioid

Fact or Myth

Elders tend to report more pain

as they age.

Page 5: Myth of opioid

MYTH

Many elders tend to not report their pain

because they think it is a natural part of growing

older.

Page 6: Myth of opioid

Fact or Myth

Opioids should not be considered when treating elders with severe pain.

Page 7: Myth of opioid

MYTHOpioids are the first 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.

Page 8: Myth of opioid

Fact or Myth

Effective pain control improves the ability to fight

disease.

Page 9: Myth of opioid

FACT

One side effect of unrelieved pain is a compromised

immune system.

Page 10: Myth of opioid

Fact or Myth

Constipation is a manageable side effect of

opioid use.

Page 11: Myth of opioid

A bowel program must always be initiated with

opioid use.

FACT

Page 12: Myth of opioid

True or False

Communication is a key component in good pain

management.

Page 13: Myth of opioid

Communication must occur between all

persons/departments.

TRUE

Page 14: Myth of opioid

Name three reasons why families or caregivers may not recognize or believe elders’ reports of pain.

Page 15: Myth of opioid

• Fear of addiction• Culture• Fear of side effects• Don’t want loved

one to be “targeted or labeled”

• Knowledge deficit

Page 16: Myth of opioid

Name three barriers to good pain management by health care providers.

Page 17: Myth of opioid

• Personal biases• Inadequate pain

assessment skills• Lack of knowledge• Lack of time• Fear of patient addiction

Page 18: Myth of opioid

Name three barriers to good pain

management by physicians.

Page 19: Myth of opioid

• Fear of legal 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

Page 20: Myth of opioid

Give three reasons elders

may not report pain.

Page 21: Myth of opioid

• Worry about cost• 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

Page 22: Myth of opioid

True or False

A person’s pain is whatever they say it is and exists whenever

they sayit does.

Page 23: Myth of opioid

This is the definition advocated by Margo

McCaffery and is subscribed to by many

pain management programs.

TRUE

Page 24: Myth of opioid

Give three signs of painthat might be exhibited by cognitively impaired elders.

Page 25: Myth of opioid

Changes in emotion (tears)

Changes in movement (restlessness)

Verbal cues (whimpering, screaming)

Facial cues (grimacing) Changes in body

position (guarding)

Page 26: Myth of opioid

What does WILDA stand for?

Page 27: Myth of opioid

Words to describe painIntensity of the painLocation of the painDuration of painAggravating/Alleviating factors

Page 28: Myth of opioid

What words might a person

use to describe Neuropathic pain?

Page 29: Myth of opioid

• Shooting• Stabbing• Burning• Tingling• Numbness• Radiating

Page 30: Myth of opioid

What words might a person use to describe

Somatic and/or Visceral pain?

Page 31: Myth of opioid

Somatic – aching, throbbing, gnawing

Viceral – cramping, pressure, deep aching, referred

Page 32: Myth of opioid

True or False

Pain medication can not be administered to a person

unless they ask for it.

Page 33: Myth of opioid

Staff and family should recognize signs/symptoms of pain in individuals and

speak on their behalf.

FALSE

Page 34: Myth of opioid

True or False

Nursing is the only discipline

that needs to be educated on pain.

Page 35: Myth of opioid

All health care workers are part of the team responsible for providing effective pain

management.

FALSE

Page 36: Myth of opioid

Name three different non- pharmacological

interventions.

Page 37: Myth of opioid

MassageHeat/ColdRelaxation/

ImageryDistractionPastoral

Consult

ExerciseImmobilizationTENS

(transcutaneous electrical nerve stimulation)

AcupunctureHypnosis

Page 38: Myth of opioid

How often should the nurse complete a

comprehensive pain assessment?

Page 39: Myth of opioid

Admission/Readmission Change in pain status or

health status Each Minimum Data Set/

Outcome and Assessment Information Set (MDS/OASIS) Assessment

Page 40: Myth of opioid

Name three things to educate the elder and

family about when implementing opioids or pain management.

Page 41: Myth of opioid

Benefits of effective pain management

Options available Goal of treatment Side Effects and their

treatment (bowels!) Cost Negative effects of pain Pain symptoms – including

nonverbal

Page 42: Myth of opioid

True or False

The elderly usually have at least three

different sites of pain.

Page 43: Myth of opioid

And it is important to assess each pain site

separately and document according to

WILDA criteria.

TRUE

Page 44: Myth of opioid

List at least three differences between

acute and chronic pain.

Page 45: Myth of opioid

Acute vs. Chronic Pain

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

Page 46: Myth of opioid

What are some non-pharmacological

interventions that the departments other than

nursing can do?

Page 47: Myth of opioid

Involve in activities 1:1 room visits Aromatherapy Touch – massage,

lotion Take on walks Read Support groups

Page 48: Myth of opioid

What can administration do to support effective pain

management?

Page 49: Myth of opioid

Effective policies Adequate supplies Training/education

programs

Page 50: Myth of opioid

What does the WHO Ladder stand for and

how is it used?

Page 51: Myth of opioid

World Health Organization▪ Systematic approach to

treat mild, moderate and severe pain

Page 52: Myth of opioid

Jeopardy Game Template adapted 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

Page 53: Myth of opioid

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Fact/Myth Barriers Assessment Education Interventions