NUR369 Opioids Misuse in Australia Assessment Answer

Abstract

Both in Australia and internationally, the use of opioids and the problems that come are considered significant public health concerns. Several studies demonstrated that there is a problem with opioid hazards in both Australia and Canada. In Australia, rates of hospitalizations for opioid poisoning and opioid-related mortality have risen during the past ten years. Pharmaceutical opioids were more likely than heroin to be implicated in opioid overdose deaths and hospitalizations. This is very important to address this concern because it directly impacts the health and well-being of the patients (Jansen et al., 2021). This literature review's primary objective is to identify the key issues with the prevalence of opioid abuse in Australia. This review also needs to identify the best ways to get through the obstacles in the way of reducing the use of opiates.

Introduction

A literature review is "an evaluation of the available knowledge in a certain field that evaluates and describes earlier efforts,". A structured summary of the study materials, known as a literature review, is all that is needed to re-arrange previous knowledge and incorporate it with new data. The literature review gives all the relevant data for a research article in a prescribed format. According to Cangadis-Douglass et al. (2022) Opioid abuse is at an all-time high not just in Australia but around the world. Addicts frequently have a variety of health issues that significantly impact their mental well-being and increase their probability of accidental overdose and self-harm (Cangadis-Douglass et al., 2022). This issue is completely avoidable and deserves more attention to minimize these regrettable outcomes. Opioid addiction can affect anyone; healthy members of the community who may have experienced a sporting mishap or a work-related injury necessitating surgery or treatment are frequently prescribed such potent painkillers without awareness of or assistance with how dangerous these particular drugs are or the potential complications that may arise. Once these people are completely addicted to opioids, both their mental health and general health status deteriorated. In Australia and around the world, statistics on prescription opioid fatality, including accidental overdose, are at all-time highs (Karanges et al., 2017). Furthermore, over the past 20 years, there has been a steady rise in the prescription of opioid analgesics in Australia. Large community surveys and personal interview research have provided some limited evidence that some prescribed opioids are being utilized for non-medical reasons and by users of illegal drugs as substitutes for heroin. The extent of the improper use of these medications and the potential effects they may be bringing to the Australian population and its authorities are both little understood. The availability of opioid drugs is governed, and their use is tracked separately by each Australian state or territory (Donovan et al., 2018). State governments must depend on their own information systems to keep track of prescription activity since they cannot access data from the PBS that has been collected nationwide. Except for Victoria and New South Wales (NSW), all Australian states and territories have some type of central database that compiles prescription data for opioid drugs. According to Jansen et al. (2021), this is very important to analyze how It is possible to track all opioid use in Australia, including non-subsidized prescribing, using PBS and DUSC data (Jansen et al., 2021). This will undoubtedly help in reducing the frequency of opiate misuse. The Australian Government recognizes the critical need for a national guideline that combines high-quality scientific information to support physicians and experts in opioid prescribing as part of its action plan to promote the appropriate use of opioids. In this context, the study was conducted to review the literature on the Opioid Pandemic and the prevalence of opiod misuse in Australia (Hauser et al., 2017).

Aim

Commence on the research pathway and conduct a literature review on the Opioid Pandemic and the prevalence of opioid misuse in Australia.

Research Questions

What are the causes of the misuse of opiates in Australia?

How many populations of healthcare professionals are aware of the appropriate conditions to prescribe Opioids?

Research Objective

To reduce the Opioids misuse prevalence in Australia.

 To provide effective strategies for removing obstacles and reducing the prevalence of opioid misuse.

Inclusion and Exclusion Criteria

While screening via abstracts and titles, a variety of studies (journals, research papers, case studies, systematic reviews, and comparative analyses) are used in the study. After taking into account the inclusion criteria for this literature evaluation, studies with the greatest relevance to the research aims are cited in the publication. Additionally, only peer-reviewed full-text articles that were released between 2017 and 2022 will be taken into account for the literature review. Editorials, newspaper articles, and commentary were excluded from this literature review based on its inclusion criteria. The study did not include any papers that were published in languages other than English. The exclusion criteria for this study include papers that did not match the inclusion criteria. Furthermore, PubMed and Google Scholar were used as the primary sources for the study's literature and data. The participants in the study were individuals who were older than 18 years old. Individuals voluntarily and formally consented to the study's methods. The study includes healthcare professionals who treat patients who misuse opiates as well as individuals who develop illnesses as a result of opiates.

Results

Table 1 presents an overview of the research's findings. During the initial literature search, 250 distinct publications were discovered in the Medline, Google Scholar and PubMed databases. 180 distinct items were available for title review after duplicate articles were removed. The title of an article was discarded if it was irrelevant or did not match the search criteria. 60 articles were left for the review of abstracts after the article titles had been evaluated. Candidate abstracts from the remaining papers were disregarded since they didn't apply or didn't fit the criteria for the search. For this review, seven studies were determined to be acceptable.

Table1: Summary of the results

Discussion

According to Douglass et al. (2022), In particular, in Australia, the rise in prescription opioid usage and harm is of concern on a global scale. Despite the lack of reliable evidence for their long-term advantages, the increased use of opioids has mostly been linked to their prescription for persistent non-cancer pain. According to Australian studies, during the past ten years, general practitioner visits for chronic pain have increased by 67% (Cangadis-Douglass et al., 2022). Furthermore, the studies of Karanges et al. (2017) state the benefits of using different data to analyze and interpret trends in prescription drug use over time. This approach not only lessens the chance that results could be interpreted incorrectly because of the constraints of a particular indicator, but it can also offer insightful information about the variables influencing usage changes. In order to determine the likely contribution of variations in average dose, duration of treatment, and the volume of the treated group to changes in opioid usage in Australia, they have integrated three volume-based metrics with a straightforward person-level statistic in this study (Karanges et al., 2017). The results of Lalic et al. (2018) studies state that in Australia, the extra medical use of POAs (prescription opioid analgesics) has been linked to a number of negative effects, including deadly and non-fatal overdosing. Male gender, age between 30 and 49 years old, substance abuse, and concurrent use of benzodiazepines, antidepressants, or other centrally acting drugs were all risk factors for hazards. According to Winfried et al. (2017), In most developed nations, the use of prescription opioids for patients who suffer from non-cancer pain (CNCP) has increased significantly due to compassionate campaigning for better chronic pain management and active advertising of opioid formulations. An "opioid epidemic"—defined as a rise in opioid use, along with related increases in misuse, abuse, and fatalities—occurred in Australia as an unintended result of this strategy. Furthermore, according to statistics, there are many different ways that opioids can be misused, from unintentional misuse to intentional overuse for recreational purposes (Winfried et al., 2017). When given non-evidence-based advice, some patients may take their prescription opioids as prescribed, which could lead to opioid dependence. On the opposite end of the spectrum, stories of individuals injecting crushed prescription opioids indicate that a growing percentage of patients are abusing opioids on purpose.

Conclusion

In Australia and around the world, rates of prescription opioid fatality, including overdose, are at all-time highs. Significant "reason to suggest "—the practice of using opioids despite minimal evidence of their effectiveness or safety in many of these patients—has been one of the contributing factors. Patients, their families, and the healthcare system all suffer greatly as a result of opioid use and misuse. Furthermore, it is acknowledged that a larger range of variables, including limited accessibility of pain management professionals and resources, affect the use and misuse of opioids. Regulatory efforts, however, can have an impact on prescriber behaviour and result in reforms.

Clinical implications

 Policy improvements would like to prevent the typical clinical trajectory, which begins with the medically necessary use of prescription opioids, escalates to abuse and then to OUD, and then develops into trading down to less expensive black-market opioids before manifesting as overdose. Furthermore, Opioid-related harms can be avoided by allowing patients with the right therapeutic indications access to these medications through a combination of rules regulating lawful access and sensible clinical decision-making (Brown et al., 2019).

References

Bryson, E. O. (2018). The opioid epidemic and the current prevalence of substance use disorder in anesthesiologists. Current Opinion in Anesthesiology, 31(3), 388-392. 10.1097/ACO.0000000000000589

Cangadis-Douglass, H., Jung, M., Xia, T., Buchbinder, R., Lalic, S., Russell, G., ... & Nielsen, S. (2022). Using primary care data to understand opioid prescribing, policy impacts and clinical outcomes: A protocol for the OPPICO study. Research in Social and Administrative Pharmacy.https://doi.org/10.1016/j.sapharm.2022.07.041

Donovan, P. J., Arroyo, D., Pattullo, C., & Bell, A. (2019). Trends in opioid prescribing in Australia: a systematic review. Australian Health Review, 44(2), 277-287. https://doi.org/10.1071/AH18245

Häuser, W., Schubert, T., Scherbaum, N., & Tölle, T. (2018). Guideline-recommended vs high-dose long-term opioid therapy for chronic noncancer pain is associated with better health outcomes: data from a representative sample of the German population. Pain, 159(1), 85-91. 10.1097/PR9.0000000000000599

Hoffman, K. A., Ponce Terashima, J., & McCarty, D. (2019). Opioid use disorder and treatment: challenges and opportunities. BMC health services research, 19(1), 1-5. https://doi.org/10.1186/s12913-019-4751-4

Jansen, C., Baker, J. D., Kodaira, E., Ang, L., Bacani, A. J., Aldan, J. T., ... & Adra, C. N. (2021). Medicine in motion: Opportunities, challenges and data analytics-based solutions for traditional medicine integration into western medical practice. Journal of Ethnopharmacology, 267, 113477. https://doi.org/10.1016/j.jep.2020.113477

Karanges, E. A., Buckley, N. A., Brett, J., Blanch, B., Litchfield, M., Degenhardt, L., & Pearson, S. A. (2018). Trends in opioid utilization in Australia, 2006‐2015: insights from multiple metrics. Pharmacoepidemiology and drug safety, 27(5), 504-512.https://doi.org/10.1002/pds.4369

Lalic, S., Jokanovic, N., Ilomäki, J., Gisev, N., Lloyd, B., Lubman, D. I., & Bell, J. S. (2019). Harms associated with extramedical use of prescription opioid analgesics in Australia: A scoping review. Research in social and administrative pharmacy, 15(8), 925-935. https://doi.org/10.1016/j.sapharm.2018.07.001

Yang, J., Bauer, B. A., Wahner-Roedler, D. L., Chon, T. Y., & Xiao, L. (2020). The modified WHO analgesic ladder: is it appropriate for chronic non-cancer pain?. Journal of pain research, 13, 411. 10.2147/JPR.S244173

Brown, R., & Morgan, A. (2019). The opioid epidemic in North America: implications for Australia. Trends and Issues in crime and criminal justice, (578), 1-15. https://search.informit.org/doi/abs/10.3316/ielapa.510903143745172

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