Regulation of the Opioid Abuse

Prevention and Treatment Act-

HR 993
Miriam Cardenas
Opioid Epidemic: EVERY DAY:

650,000 opioid prescriptions

(By the numbers) are dispensed

3,900 people take non-

prescribed opioids

78 people die from opioid-

related overdoses
 The Opioid The opioid abuse prevention and
treatment act of 2017 (HR 993) will
Abuse require the Department of Health and
Human Services (HHS) to develop peer
Prevention and reviewed processes that aid to identify
and investigate inappropriate dispensing
Treatment Act of and prescribing of schedule I and
schedule II drugs, as classified under

2017 (H.R. 993) the Controlled Substances Act.

 Comprehensive public health approach with
six provisions
Sponsor
Bill Foster (Illinois Representative)
Policy Analysis Cosponsors
Rep. Eric Swalwell (CA)
Rep. Sean Maloney (NY)
Rep. Earl Blumenauer (OR)
Reintroduced to the Congress (February 9,
2017)
In 2014 and 2015, it was not enacted.
Committee:
House Energy and Commerce
Currently being reviewed
No vote history
Prognosis: 1% chance of being enacted
 1. One-year pilot programs to evaluate
the patterns of prescribing and
dispensing of schedule II and III
Six Provisions substances.
2. Advanced training programs for safe
prescribing of opioid substances.
in Policy 3. The screening of patients for drug
abuse before opioid prescription.
4. Assessing the use of naloxone, by
the FDA, without prescription.
5. Increasing opioid disposals and
limiting opioid dispensing in the
emergency departments.
6. Reviewing opioid and heroin abuse
programs, federal policies, and best
practice for the reduction of drug
abuse.
Ethical Implications & Code of Ethics
Provision Three:
Nurse promotes, advocates
for, and protects the rights,
health, and safety of the
patient
As patient advocates it is our
responsibility to preserve
human rights and health
Untreated pain can lead to
poor quality of life
Adequate pain treatment is
a human right (Brennan,
2007)
Properly screen patients
before prescribing opioids
to preserve patient health
Ethical Implications & Code of Ethics
Provision Four:
Nurses have the authority,
accountability, and
responsibility for nursing
practice; makes decisions;
and takes action consistent
with the obligation to promote
health and to provide optimal
care
Nursing responsibilities:
Properly screen for abuse
Maintain safe parameters for
prescription of opioids
Monitor long-term opioid use
Patient education
Patient education is KEY
Educate patients on the
proper use and disposal of
opioid drugs
Potential side effects
Risk for opioid diversions
 Ethical Principles
BENEFICENCE- to do good
Opioid therapy proven to be
effective/beneficial for pain
management
Benefits range from high to
low
High benefit for severe pain
Zero benefit if opioid is used
for drug abuse and
nontherapeutic uses
NON_MALEFICENCE-
minimize harm or the risk of
harm
Consider the risk for
dependency and addiction
32% of patients misuse
opioids by the 1-year follow-up
Screen patients for misuse
and abuse of opioids
Initial screening and
assessment for history of
opioid addiction and abuse
 Ethical Principles
AUTONOMY- individual right JUSTICE- fairness and equality
to make choices Pain is the fifth vital sign
Patients have the right to Subjective assessment
consent to or decline Based on patients stated level
treatment Ethical considerations:
Patient education is KEY Undertreated pain can resemble
Educate patients so that that of a person with an addiction
they can make the best Uncontrolled pain can coexist
decisions with an addiction
Patients with an addiction should
be respected and given a proper
pain assess.
Cultural Views Over 100 million Americans suffer from
acute or chronic pain.
Opioids used for the treatment of
moderate to severe pain.
Attach to opioid receptors and
reduce passage of pain
The US makes 4.6% of worlds population
Americans consume more than 99%
of worlds supply of hydrocodone
opioid (U.N. Report, 2017).
High Opioid use due to:
Minimal constraints on marketing by
pharmaceutical companies
Culturally, Americans believe that
life is perfectible and that all pain
can be alleviated (Washington Post,
2017).
 BIBLE VERSE: 1 Corinthians 16:14
states to let all that you do be done
in love.
Spiritual View Act in love

Maintain non-judgmental
attitude

Respect all patients

Be sensitive toward opioid

abusers
References
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Brennan, F., Carr, D., and Cousins, M. (2007). Pain Management: A Fundamental Human Right. International Anesthesia Research Society, 105 (1).

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v/

Department of Health and Human Services. (2016). The opioid epidemic: by the numbers. Retrieved from
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Foster, B. (2017, February 10). H.R.993 - 115th Congress (2017-2018): Opioid Abuse Prevention and Treatment Act of 2017. Retrieved July 04,
2017, from https://www.congress.gov/bill/115th-congress/house-bill/993

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References cont.
Manworren, R., and Gilson, A. (2015). Nurses role in preventing prescription opioid diversion. American Journal of Nursing. 115 (8), 34-40.

Moghe, S. (2016, October 14). Opioids: From 'wonder drug' to abuse epidemic. Retrieved July 03, 2017, from
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https://medlineplus.gov/magazine/issues/spring11/articles/spring11pg9.html

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SciPol (2017). Opioid abuse prevention and treatment act of 2017 (HR 993, 115 th Congress). Duke science and technology. Retrieved July 23, 2017 from
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The role of the nurse in preventing opioid abuse. (n.d.). Retrieved July 03, 2017, from http://minoritynurse.com/the-role-of-the-nurse-in-preventing-
opioid-abuse/

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