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The Role of Clinicians and Other Healthcare Workers in Combating the Opioid Crisis

According to the HealthStream webinar, “Opioid Misuse and Addiction: Strategies for Preparing Clinicians and Staff,” healthcare staff play an important and often unique role for victims of the opioid crisis. Our presenter, Dr. Andrew MacPherson, a 20-year emergency trauma and EMS physician in Victoria, British Columbia, Canada, has been a member of the American Red Cross Scientific Advisory Council for the last 15 years, and has served as Chair for the First Aid Sub Council. He i credited as an author of the 2015 ILCOR First Aid guidelines and has served as a leading educator for medical students, residents, paramedics, and practicing emergency physicians throughout his career.

A Unique Role When Patients Are Vulnerable

MacPherson reminded his audience about the “unique role of clinicians and healthcare workers who often find people in their most vulnerable situations.” When people struggling with abuse and addiction encounter people in other professions, for example bankers and service workers, they are often able to control the social situation. However, when addicts are in “a healthcare environment and experiencing a medical event, they are usually more vulnerable and less likely to have surrounded themselves with layers of defense.” He offered that healthcare professionals should be able “to recognize what's happening if we pay attention to the cues.”

De-Stigmatize and Communicate

MacPherson emphasized the need to de-stigmatize this situation, “Patients may not come in identified as narcotic users, and shouldn't be labeled unnecessarily. Instead, he advised that we should provide them with the opportunity to talk about their issues and problems. MacPherson insists that “We can identify the signs and symptoms of misuse in the early stages.” This is before a lawyer, judge, or accountant sees tell-tale changes in a client. He points out to how beginning users start to really slip in their social status, because they're no longer able to participate in their job. He is optimistic that “We can step in early to help them return to work before they become part of a marginalized population.” The goal after identifying the problem is to implement treatment plans early—that’s why it is important to be honest and upfront about problems that are easy to see.

Know about Treatment Access and Solutions

Because the treatment system is often a complex patchwork, it's our job in healthcare to know where those who suffer can get help. Different populations may fit better to different treatment options, depending on sociological background. For example, MacPherson offered that “a lawyer downtown who is also an addict shouldn’t automatically go to the treatment center by the shooting gallery around the corner.” The goal for everyone in healthcare needs to be “to reduce harm amongst people struggling with opioid misuse.”

Common Signs of Overdose

MacPherson described the signs of overdose that are commonly identified in a clinical situation—three things that often occur together include:

  1. Pinpoint pupils
  2. Respiratory rates decreased or zero
  3. Unconsciousness, or someone with difficulty staying awake 

Some other indicators may include cyanosis, or a blue-like color that makes them seem like they are changing color, and track marks. MacPherson recommends that “clinicians and staff should be prepared on what to do when you do come across somebody who's likely experiencing an opioid overdose.”

Access the full Webinar, the first in our three-part series, Managing Opioids, Pain, and Chronic Disease, Critical Steps In Addressing Population Health.

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