According to the Centers for Disease Control and Prevention, an average of 130 people will die of an opioid overdose everyday (Centers for Disease Control and Prevention, 2018). In response, the American Nurses Association (ANA) adopted a comprehensive stance regarding the opioid epidemic and addressed the registered nurse's (RN's) role as a qualified and well-positioned provider who can play a key role for patients battling substance use disorder (ANA, 2016). However, the ANA focuses on prevention, prescribing, and access to naloxone and does not directly address strategies for the RN in the inpatient, acute care setting (ANA, 2016; Painter, 2017). Sharma, Lamba, Cauderella, Guimond, and Bayoumi (2017) report that most inpatient settings do not have a clear definition of the nurse's role in the complex care of a person with substance abuse disorder or how to provide harm reduction education.
Harm reduction is defined as a way of preventing disease and promoting health that "meets people where they are, rather than making judgments about where they should be in terms of their personal health and lifestyle" (North Carolina Harm Reduction Coalition, 2018). Harm reduction efforts for people with substance use disorder focus on minimizing the risks and harms associated with unsafe drug use, such as disease transmission, infection prevention and education, and death from overdose (North Carolina Harm Reduction Coalition, 2018).
At present, the acute care nurse's primary focus is understandably on managing the acute complications of a patient's substance use, and harm reduction education is typically not addressed (Sharma et al., 2017). However, by equipping nurses with clear guidelines, they can expand the impact of their care by implementing evidence-based harm reduction techniques. Harm reduction is a practice that can benefit not only the person with a substance abuse disorder but also society as a whole. For example, harm reduction practices and education have shown to help reduce hospitalizations and costs associated with them (Dubois, 2017). Successful and effective harm reduction education would include infection control measures such as the way disease is spread and overdose prevention as well as health promotion and the management of symptoms. A specific example would include teaching the basics of acquiring, using, and disposing sterile drug use equipment (Sharma et al., 2017). Nurses can collaborate with social work colleagues to introduce patients to local resources, such as clean needle exchange programs, and how to locate recovery and support centers.
When nurses provide the education, patients are subsequently empowered to make informed decisions about their health and thus better manage their disease. Nurses have high demands on their time; asking them to provide harm reduction education may seem as only one more "task." However, when we consider the cost of this illness to individuals, families, and society and the customary role nurses play in educating others about their illness (congestive hard failure, diabetes, hypertension, etc.), harm reduction education seems a perfect fit for the professional RN. The first step for acute care organizations is to recognize the stigma surrounding substance abuse and the results of that stigma on caregiver attitudes. Sharma et al. (2017) recommend de-stigmatization education for all healthcare workers as a priority.
Sometimes, a statistic does not easily translate into a human life. Healthcare providers, and most especially RNs, are urged to bring this epidemic in perspective: Thousands of lives are being lost, children are losing their parents, and parents are losing their children. Taking no action is an action; doing nothing seems unacceptable especially given that we possess the knowledge and ability to help. When acute care settings implement harm reduction techniques, nurses can provide this vulnerable patient population the tools they need to live their healthiest lives.
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