Chronic Pain Management among the Elderly and Drug Addicts
Pain management is one of the critical roles that a nurse has to play to ensure the comfort and improved quality of life among his or her patients. Pain is uncomfortable and makes the patient’s condition get worse and interferes with effective coping. Different drugs are used in pain management, and pain can be adequately managed with a comprehensive health assessment. Acute pain disappears with control but chronic pain can recur once in a while and could be debilitating. Pain management is challenging among the elderly and drug addicts since they have altered pharmacodynamics and pharmacokinetics (Kress et al, 2014). The older adults and the drug addicts are unique categories and therefore need a special consideration to enhance comfort and quality of life. This literature review is a comparison of research done concerning pain management in the elderly by different authors.
Kress et al. (2014) evaluated the extent of untreated pain among the elderly and found that it is a problem was extensive. They recommended that there is need to have a change of approach in the management of pain among the elderly. Achterberg and others (2013) wanted to establish the challenges faced in the management of pain among the old people with dementia and found that pain assessment was a significant challenge for intervention. Other researchers sought to establish strategies for careful management of elderly patients with chronic pain and confirmed that there are still gaps in the management of pain among the elderly (Corbett et al., 2014). Similarly, Rastogi & Meek (2013) evaluated the need to apply an individualized pain management plan for the elderly comprised of an informed and comprehensive guide.
There was also a lot of research done regarding the management of chronic pain among the drug addicts. Such individuals have abused many of the opioids which are commonly used in pin management and therefore may not respond to them when in pain. Vowles among others (2015) wanted to determine the rates of problematic opioid use and established that up to 30% of the general population have a problematic opioid use. Dart et al. (2015) focussed on determining the trends in opioid analgesic abuse and mortality in the united states and discovered that the habit has been on the rise since 2002 with a plateau from 2010. Edlund et al. (2014) sought to establish how opioid prescription could be associated with opioid abuse and dependence among individuals with noncancer pain and found that the patients with non-cancer pain being managed by opioids were at a higher risk of abusing them which then affects their future pain management. Howe & Sullivan (2014) discovered that psychiatric services were needed in chronic pain care.
Most of the studies were quantitative descriptive in which the authors purposed to explain phenomena as it is. They analyzed the data that was already available for the management of chronic pain among the elderly and drug addicts and concluded from the information. The authors wanted to build on what was known about pain management from different research work. The results also acted as a basis for a recommendation on what is supposed to be changed as far as the management of pain among this particular category of people is concerned. The authors identified gaps in practice that ought to be filled to ensure adequate control of pain among the elderly and the drug addicts.
The sample population for all the eight studies was the same due to the method of data collection used. The researchers sought for information from different databases containing the keywords for the review which include chronic pain management, the elderly and drug addicts. They chose the research articles that had relevant information that related to pain management among the elderly and drug addicts. The authors of the eight research jobs, therefore, relied on what the other individuals have already discovered about the issue of managing pain among the elderly and opioid addicts. The method of data collection also appeared to be the cause of the study limitations. The authors relied on data search to obtain information for use in the research, and some data could have been omitted or irrelevant data included. The authors were not the original people to investigate the issue, and therefore there could be errors in the findings.
Conclusion
The management of pain among the elderly and drug users is a very complicated issue and needs a careful approach to treatment. Different researchers have worked on the subject and came up with some data that can be applied in managing pain among this particular category of patients whose pharmacokinetics and pharmacodynamics are unique. Pain management practices in the elderly and drug addicts are characterized by various gaps that need to be filled. It is essential to conduct a thorough history taking to establish individuals at risk of poor pain control due to opioid dependence. The elderly and drug addicts also need an individualized plan of care that meets the unique needs of each patient. Nurses should also show empathy to patients and use a non-judgemental approach while attending to opioid dependants to help them regain their health.
References
Achterberg, W. P., Pieper, M. J., van Dalen-Kok, A. H., De Waal, M. W., Husebo, B. S., Lautenbacher, S., … & Corbett, A. (2013). Pain management in patients with dementia. Clinical interventions in aging, 8, 1471.
Corbett, A., Husebo, B. S., Achterberg, W. P., Aarsland, D., Erdal, A., & Flo, E. (2014). The importance of pain management in older people with dementia. British medical bulletin, 111(1).
Dart, R. C., Surratt, H. L., Cicero, T. J., Parrino, M. W., Severtson, S. G., Bucher-Bartelson, B., & Green, J. L. (2015). Trends in opioid analgesic abuse and mortality in the United States. New England Journal of Medicine, 372(3), 241-248.
Edlund, M. J., Martin, B. C., Russo, J. E., Devries, A., Braden, J. B., & Sullivan, M. D. (2014). The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic non-cancer pain: the role of opioid prescription. The Clinical journal of pain, 30(7), 557.
Howe, C. Q., & Sullivan, M. D. (2014). The missing ‘P’in pain management: how the current opioid epidemic highlights the need for psychiatric services in chronic pain care. General hospital psychiatry, 36(1), 99-104.
Kress, H. G., Ahlbeck, K., Aldington, D., Alon, E., Coaccioli, S., Coluzzi, F., … & Mangas, A. C. (2014). Managing chronic pain in elderly patients requires a CHANGE of approach. Current medical research and opinion, 30(6), 1153-1164.
Rastogi, R., & Meek, B. D. (2013). Management of chronic pain in elderly, frail patients: finding a suitable, personalized method of control. Clinical interventions in aging, 8, 37.
Vowles, K. E., McEntee, M. L., Julnes, P. S., Frohe, T., Ney, J. P., & van der Goes, D. N. (2015). Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain, 156(4), 569-576.
