Opioid Safety, Respiratory Compromise

Overdose Risk Assessment in Chronic Opioid Therapy

Before recommending opioid therapy, assess patients for risk of overdose. In this article, Peggie L. Powell, MSN, APRN, FNP-BC a family nurse practitioner, discusses using RIOSORD, the first tool intended to provide clinicians with the clinical decision support to assess the risk of OSORD and determine the possible need for naloxone. 

By Peggie L. Powell, MSN, APRN, FNP-BC

Over 100 million people suffer from chronic pain in the United States, and for some of these people, chronic opioid therapy (COT) may be appropriate. Despite the limited availability of strong scientific evidence to support long-term opioid therapy for chronic noncancer pain, COT has increased substantially over the years along with an increase in drug related deaths.

Prescription opioid related deaths have quadrupled since 1999 in the United States and approximately 80% of deaths are due to unintentional overdose. The addictive nature of opioids makes them vulnerable to misuse and abuse. Persons whom take opioids for their intended purpose can risk significant adverse events if they do not take them as prescribed (e.g., taking more than prescribed and taking them in combination with other psychotropic medications and/or alcohol). Opioids can depress the central nervous system and result in serious, life-threatening consequences such as respiratory depression, sedation, coma, and potentially death. Read More