Opioids, Related Substances and Opioid Use Disorder (OUD) (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 So, when we're talking about opioids, what are we talking about? Well, we're talking about opium, heroin, codeine, Demerol, meperidine.

    00:16 We're talking about oxycodone and Percocet, hydrocodone, which is also sold under the names of Vicodin, Norco, and Lortab.

    00:30 We're talking about morphine, MS Cotin and Kadian, and hydromorphone, which is Dilaudid and Exalgo.

    00:42 I'm sure that these names are not unfamiliar to you if you have been working in a hospital because they are the analgesics, especially post-operatively, that we go to.

    00:56 Others that might be quite common to you are fentanyl sold under Actiq, Fentora, Duragesic, Subsys, Abstral, and Lazanda.

    01:12 Then there's methadone, also sold under the names of Dolophine and Methadose, and oxymorphone, which is also sold as Opana.

    01:24 You have tradamol which is sold under the name of Ultram, Ultracet, and Ryzolt.

    01:33 Carfentanil, which is a fentanyl analog, this is usually known as the elephant tranquilizer.

    01:42 And then, there's buprenorphine, which is a partial opioid agonist and analgesic.

    01:50 So, all of those medications should be somewhat familiar to the nurse because many of them are used on a daily basis to help a person who's in pain.

    02:06 So, what happens? Well, just like other substance use disorders, what is used in one system and used correctly can then become abused and misused.

    02:23 So, what is opioid use disorder? Well, according to the Diagnostic and Statistical Manual of Mental Disorders or the DSM-5, it is a disorder that is chronic, lasting the person's whole life.

    02:37 It is identified as having at least two of the following symptoms over a 12-month period.

    02:45 Now, as I go over these symptoms, I want you to be thinking about what we had said about alcohol use disorder.

    02:55 Substance use disorders usually all have the same kinds of symptoms.

    03:01 The difference is the substance.

    03:05 So, using opioids in amounts larger than prescribed or for longer than was originally intended.

    03:15 Experiencing a craving or desire for opioids with an inability to cut back or control the use of it.

    03:25 The person with opioid use disorder also develops tolerance, meaning that the person requires increasing amounts in order to get the same desired effect.

    03:38 And that person is investing a lot of time and a lot of energy to get the drug, to use the drug, or to recover from the effects of using that drug.

    03:53 The results end up being an increasing problems at school, at home, at work, an inability to maintain relationships or meet the responsibilities.

    04:07 And then, that slides into leading the person to choosing opioids over all other activities.

    04:17 And so, most of their time is spent trying to get to it, using it, recovering from it, and the relationship with opioids, with this substance, takes priority of all other relationships.

    04:32 And then, the person continues to seek and use opioids even when the situation is risky or harmful.

    04:40 When they have to go into neighborhoods where they normally would not have gone, meet with people they don't know to buy the drugs.

    04:47 And despite all the emotional and physical problems that they are experiencing, the person continues to make these - using this drug their priority.

    05:02 And as they do, their problems only get worse.

    05:07 Now, if the person decides they wanna stop using opioids, withdrawal is their result.

    05:14 And so, the person continues to use opioids because that person now, instead of using it to get high, that person is now using it to make sure that they don't experience withdrawal.

    About the Lecture

    The lecture Opioids, Related Substances and Opioid Use Disorder (OUD) (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Opioid Use Disorder (Nursing).

    Included Quiz Questions

    1. Meperidine
    2. Methadone
    3. Hydrocodone
    4. Spironolactone
    5. Decitabine
    1. The client who has been using tramadol for the last 2 years who reports that they have been taking their medication even when they are not experiencing pain, is requiring more and more medication for the desired effect, and has started buying extra pills from an acquaintance when their doctor decreased their dosage
    2. The client who has been using fentanyl for the last month who reports that they are having to use more medication than before to effectively treat their pain, and who is requesting alternative medications and therapies, as their goal is to stop using fentanyl as soon as possible
    3. The client who has never used opioids before this week, has gone through a 7-day hydromorphone prescription in 5 days, and is requesting an early refill and an increased dosage
    4. The client who has been using oxycodone for the last 3 years, only takes the medication when they are experiencing increased pain, and finds that they have pills leftover, even after their prescription is supposed to be finished
    1. Having at least two of the specified symptoms over a 12 month period
    2. Having at least five of the specified symptoms over a six month period
    3. Having at least six of the specified symptoms over a 12 month period
    4. Having at least three of the specified symptoms over a six month period

    Author of lecture Opioids, Related Substances and Opioid Use Disorder (OUD) (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN

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