Reducing Addiction Stigma: Recommended Reading in AJN’s January Issue

The January issue of AJN is now live.

What are the consequences of addiction stigma, and what steps can nurses take to reduce biases related to substance use? Learn more in this month’s CE, “Reducing Bias Against People with Substance Use Disorders.”

Get your 2024 reading list started: here are the winners of our annual Book of the Year Awards.

“Original Research: Predictors of COVID-19 Vaccine Hesitancy Among Asian Indians in the United States: A Cross-Sectional Descriptive Study” examines the relationships between select demographic variables and COVID-19 vaccine hesitancy among this population.

In “Improving Discharge Teaching for Adult Patients with an Ileostomy,” the authors discuss a QI project they conducted to decrease patient-initiated postdischarge inquiries by using a FAQ handout at discharge.

See also the extensive health care news sections, the Journal Watch and Drug Watch sections, a Viewpoint column on solving the nursing shortage, an AJN Reports on the U.S. maternal health crisis, and more.

A note on the cover:

This month’s cover honors Barbara J. Braden, PhD, RN, FAAN, who pioneered risk assessment and risk-based prevention of pressure injuries. Braden passed away in June 2023; read a tribute written by […]

2023-12-26T11:05:07-05:00December 26th, 2023|Nursing|0 Comments

Bringing the Faces of Addiction—and Recovery—to Schools

Nancy Labov, RN, CADC. Photos courtesy of Nancy Labov.

A nurse speaks from experience.

In nursing school, Nancy Labov felt a kinship with the patients she encountered during a rotation on a rehabilitation unit. She realized that she wanted to spend her career caring for patients like them. Their struggles with addiction struck a chord: alcoholism ran in her family, and she, too, had a substance abuse problem, though she was in denial about it at the time.

In her mid-20s, Labov got sober; she has maintained her sobriety ever since. She’s also persisted in her mission to help people recover from addiction. As an RN and a certified alcohol and drug counselor, she has spent the past three decades working on rehab and detox units across the country.

Labov is also the founder of Alumni in Recovery (AIR)—a nonprofit through which young adults in recovery give talks at schools in the communities they grew up in. As she discusses in the July Profile in AJN, “Helping Students See the Realities of Addiction and Recovery,” the New Jersey-based volunteer organization fights stigma by opening a dialogue about addiction and showing teens a young, local, and relatable face of recovery.

A peer-to-peer approach is key.

“How do we […]

Recent Decline in U.S. Opioid Prescriptions: Good News But Some Concerns

by frankieleon/ via flickr by frankieleon/ via flickr

It was widely reported in the past week that there have been steady declines in the number of opioid prescriptions in the U.S. for the past three years, with the declines the steepest in some of the states considered to have the worst opioid misuse crises.

This is good news, suggesting that efforts to address some problem areas like renegade pain clinics prescribing for profit, patients who go from doctor to doctor seeking opioid prescriptions, and the diversion of legitimate opioid prescriptions may be starting to bear fruit.

A balanced overview of the situation can be found in this New York Times article. The authors also acknowledge that patients in pain are now facing new hurdles to pain relief, quoting the director of one prominent medical school’s program on pain research education and policy: “The climate has definitely shifted. . . . It is now one of reluctance, fear of consequences and encumbrance with administrative hurdles. A lot of patients who are appropriate candidates for opioids have been caught up in that response.”

Much of the reporting on the opioid epidemic lumps all people who take opioids into one big statistical brew. While startling and alarming numbers about overdoses from legal and illegal opioids steal the headlines, little media and scholarly analysis focuses on the lower […]

CDC Opioid-Prescribing Guideline for Chronic Pain: Concerns and Contexts

by frankieleon/ via flickr by frankieleon/ via flickr

By Jacob Molyneux, senior editor

The CDC’s new Guideline for Prescribing Opioids for Chronic Pain was released this week. The context for this comprehensive new guideline is widespread concern about opioid-related overdose deaths and substance abuse in the U.S.

The guidelines make 12 main recommendations, among them the following:

  • nonpharmacologic or nonopioid pharmacologic treatments should be considered “preferable” first-line therapy for those with chronic pain.
  • a daily opioid dosage limit of morphine milligram equivalents should be imposed.
  • immediate-release opioids should be prescribed before moving to extended-release formulations.
  • urine testing should precede new opioid prescriptions for chronic pain and treatment goals should be set.
  • clinicians should prescribe the lowest possible number of days’ worth of medication for acute pain (often three days or less).
  • prescription drug monitoring program (PDMP) databases should be consulted to determine patients’ past histories of opioid prescriptions.

Some of the recommendations would seem to be no-brainers, such as consulting PDMPs when writing new prescriptions. Others, such as a “one-size-fits-all” daily dosage limit and restrictions on the use of extended release formulations, have raised alarms among pain management experts. See, for example, “I’m Worried About People in Pain,” a recent AJN Viewpoint essay by Carol Curtiss, a nurse and pain management expert, who notes the increased stigmatization experienced by pain patients and the chilling effects of […]

The Blame Game

By Jacob Molyneux, senior editor

TheBlameGameIllustrationThe Reflections essay in the April issue of AJN is called “The Blame Game.” It’s by a nurse who finds herself visiting a family member in the hospital during her shift break at the same hospital. In her distress, she gets little relief or reassurance from the harshly judgmental nurse she encounters.

The vividly told episode raises the question: can the act of casting judgment on another person diminish our ability to see these people as complete human beings, whatever their failings? And also this question: what is the proper attitude of nurses toward their patients?

Please give it a read and see what you think. Is this nurse’s attitude an exception, or more common than it should be, as the author suggests? Here’s a brief quote from near the end:

There seems to be a dangerous epidemic of clinicians blaming patients for their health issues. As a nursing student, I saw more and more of this attitude. The health care profession seems to have evolved a culture of accusation and attack against patients, a group we should be empowering and protecting.

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