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Annotated Bibliography

Group 1: Paulina Torres, Desiree Nieto, Clarissa Legarretta, Natali Legarretta, and

Stevan Sifuentes

The University of Texas at El Paso

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Clark, M. (n.d.). Benefits and Risks of Opioids for Chronic Pain Management. Retrieved March

28, 2019, from https://www.hopkinsarthritis.org/patient-corner/disease-

management/benefits-and-risks-of-opioids-for-chronic-pain-management/

In this article, Clark refers to the good that opioids have brought into the medical

profession and how much it helps patients in the Johns Hopkins Arthritis Center, where

most of the studies show in the article are done. He goes on to say that one study showed

that opioids were excellent treatments for non-malignant pain such as lower back pain,

post-herpetic neuralgia, and painful peripheral neuropathy with it decreasing pain and

even improving function and movement for those taking it. Furthermore, Clark states that

in a study to determining how “addictive” opioids were, out of 12,000, only four of them

without a history of substance abuse developed dependency. This article is useful because

it shows the opposite side of the spectrum regarding why the use of opioids is so

important. It gives a doctor’s perspective on the need for these drugs and it gives the

paper the group is writing a different angle to what needs to be done, as well as why it is

happening.

Fortune Journals, A. D. (2018, January 15). The Opioid Epidemic: Impact on Children and

Families. Retrieved from http://www.jpsychiatrypsychiatricdisord.com/articles/the-

opioid-epidemic-impact-on-children-and-families.html

In this article, Dirks emphasizes the danger opioid addiction can pose to not only the

patient but also the patient’s family. One concern that is discussed pertains to pregnant

mothers who continue to use opioids throughout their pregnancy. These women often

decline prenatal care which leads to their infants being born with symptoms of Neonatal

Abstinence Syndrome (NAS) which include withdrawal and even seizures. Dirk also
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states that many of these children born with NAS will be put into foster care. However,

the children of opioid addicts who do remain with their parents throughout their

childhood will often live in a very unstable environment. Dirk highlights that about eight

million children live with at least one parent who suffers from addiction. The children of

people who struggle with opioid addiction are also more likely to develop an addiction of

their own in adulthood, or even earlier. These children are also more likely to develop

depression and anxiety, as they are often abused by their parents. This article is useful

because it examines the severe effects that addiction to prescription opioids can have on

users of opioids as well as the children of the user from the time of pregnancy and

throughout the rest of their lives.

Keast, S. L., Nesser, N., & Farmer, K. (2014). Strategies aimed at controlling misuse and abuse

of opioid prescription medications in a state Medicaid program: A policymaker’s

perspective. The American Journal of Drug and Alcohol Abuse,41(1), 1-6. Retrieved

from https://www.ncbi.nlm.nih.gov/pubmed/25490606

Keast, Nesser and Farmer state that many American societies are fighting to stop the

misuse and abuse of prescription opioids by experiencing critical evaluations and various

other means mandated by the government, against not only the individuals tackling

addiction, but pharmaceutical institutions, including policymakers. Furthermore, these

authors also note that policymakers hold the sole responsibility to protect the population

it serves from the consequences of opioid addiction, regardless of any government

regulation or methods for fixing this issue. With the use of these key points, the authors

give an insight of what can be done to help prevent opioid addiction as well as who holds

a high responsibility for the issue slowly growing to a worldwide crisis.

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Mack, A. (1970, January 01). MARIJUANA AND PAIN. Retrieved

from https://www.ncbi.nlm.nih.gov/books/NBK224384/

In this situation, the Mack acknowledges the problem with pain killers, stating that

society often is just covering up the real problem and adding to it the horrible side effects

that come with some of these medications. He spends much of the time in the article

talking about how the benefits from cannabinoids in dealing with acute and chronic pain.

Though only a few studies have been done with medical marijuana because it is illegal, it

does show a major correlation with less pain in cancer patients as well as other major

diseases. This article is useful because it shows represents a safer alternative to the use of

opioids (pain killers) in more severe pain and has been proven by a few studies the author

states in his article. Furthermore, it also gives a reason that opioids have gotten as

widespread as it has seemingly without much realization from the public. It shows that

this negligence should stop for the opioid crisis to be remedied.

Murnion, B. P., Gnjidic, D., & Hilmer, S. N. (2010). Prescription and Administration of Opioids

to Hospital In-patients, and Barriers to Effective Use. Pain Medicine, 11(1), 58–66.

Retrieved from https://doi.org/10.1111/j.1526-4637.2009.00747.x

Murnion, Gnjidic, and Hilmer refer to a study that was conducted to describe the

prescription and administration of opioids in a tertiary referral teaching hospital where an

anonymous semi- structured questionnaire was administered to medical and nursing staff.

Aims of this study was to assess staff knowledge of pharmacology and available

preparations for the opioid crisis, however, the author noted that oxycodone was the most

frequently prescribed opioid amongst patients. The administration of opioids depended

on the nurse’s knowledge of pain management and their attitude towards pain relief. The
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poor prescribing of opioids may contribute to how much pain and inadequate treatment of

pain the patient is in with the ones most affected by the opioid crisis being those admitted

to orthopedic doctors. This article is useful because it shows where the opioid crisis is

highly located as well as what some of the nurses prescribing it are thinking when they do

it.

Opioids: The Crisis Next Door [Web log interview]. (n.d.). Retrieved March 16, 2019, from

https://www.crisisnextdoor.gov/?utm_source=google&utm_medium=cpc&utm_term=cri

sis next door&utm_campaign=Crisis Next Door – Brand

This website depicts the real lives of individuals who have spoken about their past

experiences with opioid addiction as well as statistics based on the crisis, noting that last

year, opioids killed more people than car accidents or gunshots. People from war veterans

to stay at home moms post their stories of their struggles through addiction on this

website and it allows the audience to watch short videos of people describing their

struggle with abuse and exactly the lengths they went through in order to keep their

cravings satisfied. This website really can shine a light on everyone that is affected by the

crisis next door and it allows people to feel true empathy by putting a person to the

statistics, further driving the statement that opioid addiction is a serious problem.

Sciences, N. A., Engineering, & Medicine, A. (2017, July 13). Trends in Opioid Use, Harms, and

Treatment. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK458661/.

The authors of this article state that from 1999 to 2011, the mortality rate of overdose due

to opioids has increased by four hundred percent. They also highlight the fact that

according to the Substance Abuse and Mental Health Services Administration, most

people who have abused prescription opioids began using them when they were in their
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early 20s. The interrelation between prescription opioids and heroin is also stressed,

stating that almost all heroin addicts began with the use of prescription opioids, noted by

the death rates from heroin overdose having increased by three hundred percent. Several

factors were also evaluated, in detail, as to what might affect the risk of the medication.

These include the chemical compound, the formulation, the route of administration, and

dosages. This article is useful because it discusses how addiction to prescription opioids

can lead to more serious and potentially more dangerous addictions to other recreational

drugs as well as the evaluation of each risk factor will be beneficial when considering

possible alternatives for prescription opioids.

Theisen, K., Jacobs, B., Macleod, L., & Davies, B. (2018). The United States opioid epidemic: a

review of the surgeon’s contribution to it and health policy initiatives. BJU International,

122(5), 754–759. Retrieved from https://doi.org/10.1111/bju.14446

Theisen, Jacobs, Macleod, and Davies state that opioid abuse and addiction is one of the

leading causes of devastation in the United States and in our healthcare system. There is

evidence that doctors are responsible for this dangerous crisis because of overprescribing

opioid medications. Surgeons specifically have been criticized because many post-

operative patients are receiving increased opioid prescriptions than needed, which is

leading to consequences of addiction and misuse. There are many solutions to this issue

as stated by these authors that include a prescription monitoring program, policy-level

interventions, recovery after surgery protocols, and a procedure that specifies prescription

guidelines while also having physicians and prescribers addressing post-operative pain.

This article is useful because it contains information that explains one of the reasons for

the increased use of opioids in the country, who is the most likely prescribers of the
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medication as well as it gives possible solutions to control the over-prescribing of the

drugs.

Volkow, N. D., & McLellan, A. T. (2016). Opioid Abuse in Chronic Pain — Misconceptions and

Mitigation Strategies. New England Journal of Medicine, 374(13), 1253-1263.

doi:10.1056/nejmra1507771

Volkow and McLellan state in their article that physicians lack proper knowledge about

whether, when, and how to prescribe opioids for chronic pain without increasing public

health risk due to the lack of research supported guidance. The authors also express their

understanding that opioid addiction is a widespread issue as well as how they affect the

bodies of those who take them. Furthermore, they explain that the Department of Health

and Human Services launched an initiative to reduce opioid use through medication

assisted treatments and fewer dosages. This article is useful because it gives insight of

what physicians’ knowledge is lacking when prescribing opioids while also expressing a

few solutions currently going into effect. This resource will further back the claims that

there needs to be a more complex solution to the opioid crisis than simply stopping the

prescription of them.

Vu, Q., Beselman, A., Monolakis, J., Wang, A., & Rastegar, D. (2018). Risk factors for opioid

overdose among hospitalized patients. Journal of Clinical Pharmacy and Therapeutics,

43(6), 784–789. Retrieved from https://doi.org/10.1111/jcpt.12701

According to Vu and Monolakis, most people that are hospitalized are at higher risk for

opioid abuse. A study noted by these authors in their article, showed that from 2010 to

2013, 44 cases of opioid overdose were compared to 88 cases of controls. The data was

collected in factors of age, gender, weight, the dose of the medication, renal function, and
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comorbid conditions. The ones that were at risk factor and more than likely to take

opioids were age 65 and older, hospitalized patients whether it be for Intensive Care,

renal impairment, and people with depression. This expressed the target audience for

opioid addiction as well as it may be able to be used to develop and apply measures to

prevent overdose in the future. This article is useful because it can show who is affected

directly and indirectly by opioid addiction and possible solutions so that the families of

those struggling with addiction can also receive help.