Category: Opioid Safety

Our Love-Hate Relationship with Opioids: 3 Things Clinicians Can Do to Improve Patient Safety and the Quality of Patient Care

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

Our Opioid Dichotomy

Opioids are something we love and hate, all at the same time. On the one hand, they are a great pain reliever and are often used to provide analgesia and supplement sedation during general anesthesia or monitored anesthesia care. On the other hand, opioids can be addictive and too much opioids can lead to opioid overdose and death. Justine Igwe (Nursing Student in Nigeria at the University of Nigeria Enugu Campus) recently wrote about opioids’ pain relief vs. addiction/overdose dichomotomy:

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The Need for Better Opioid Management

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

Opioids Can be Deadly

To say that opioids can kill is perhaps to overstate the obvious. According to the National Institute on Drug Abuse, overdose deaths involving any opioid have steadily risen from 2010 to the present:

“Opioid-involved overdose deaths rose from 21,088 in 2010 to 47,600 in 2017 and remained steady in 2018 with 46,802 deaths. This was followed by a significant increase through 2020 to 68,630 overdose deaths.”

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Learning About Opioid-Induced Respiratory Depression from Logan’s Death

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

An Introduction to Logan

In 2016, I had the immense pleasure of interviewing Pamela Parker, BSN, RN, CAPA about what happened to her 17-year-old son, Logan.

Pamela Parker has been a registered nurse for about 30 years. She is a recovery room nurse and, at the time of our interview, worked in the ambulatory procedure unit at a hospital in Indiana. In addition to providing patient care, Ms. Parker is a clinical educator and provides bereavement support. To help others with the loss of loved ones, she writes a blog “Hope for Grieving Mothers.”

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Sleep Apnea and Opioids is a Deadly Combination

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Sleep Apnea is a Common Sleep Disorder

Sleep apnea is a common sleep disorder. Sleep apnea patients have multiple extended pauses in breathing when asleep. This affects the oxygen supply to their bodies. As a result, approximately 20% wake up with headaches. Some suffer migraines. Still, most people think sleep apnea just disrupts sleep.

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Identifying Patients At Risk of Opioid-Induced Respiratory Depression

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Opioid-induced respiratory depression can lead to serious adverse events and even death, in hospitalized patients. In its Sentinel Event Alert #49, titled “Safe use of opioids in hospitals”, the Joint Commission stated, “While opioid use is generally safe for most patients, opioid analgesics may be associated with adverse effects, the most serious effect being respiratory depression, which is generally preceded by sedation.” The alert was retired as of February 2019 and is now addressed in the commission’s pain management standards for hospitals.

About half of in-hospital cardiorespiratory events occur on the general care floor. Often these events are fatal. Lars W. Andersen, MD (Department of Medicine, Regional Hospital Holstebro, Aarhus University & Department of Emergency Medicine, Beth Israel Deaconess Medical Center) and his colleagues concluded that acute respiratory events are common in inpatient wards in the US and are associated with a mortality rate of almost 40%.

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Researching Opioid-Induced Respiratory Depression

Editor’s note: In this article, Physician-Patient Alliance for Health & Safety executive director, Michael Wong, reflects on how the deaths of 18-year old Amanda Abbiehl set him on the path to becoming a patient safety advocate and up-coming research that PPAHS will be undertaking.

By Michael Wong, JD (Founder and Executive Director, Physician-Patient Alliance for Health & Safety)

Death From Patient-Controlled Analgesia

10 years ago today, 18-year old Amanda Abbiehl tragically died in 2010 at Saint Joseph Regional Medical Center (SJRMC).

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We Need to Rethink How We Use Opioids and Manage Pain

Financial responsibility for the opioid crisis is finally being meted out – Purdue Pharma is in the midst of settling thousands of opioid lawsuits and Johnson & Johnson has been ordered to pay $572 million for its opioid-related actions. These two pharmaceutical giants are likely just the tip of the defendant iceberg, with more lawsuits still to be filed and decided.

However, as much as some may wish to demonize opioids and their use, it should not be forgotten that opioids and their use are here to stay. Opioids are necessary for many medical procedures – could major surgery be done without opioids? As well, opioids are a necessity for many patients to manage their pain and for their chronic conditions.

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Where’s the J&J that Managed the Tylenol Crisis?

Editor’s note: In this editorial from the desk of PPAHS’s Executive Director, Johnson & Johnson could have taken a lead in the opioid crisis, but has chosen not to.

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety)

Recently, Johnson & Johnson (J&J), a company that “believe(s) good health is the foundation of vibrant lives, thriving communities and forward progress,” was ordered to pay $572 million by Judge Thad Balkman of Cleveland County District Court in Oklahoma. Reported The New York Times about the judgment:

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Preventing Opioid Overdoses and Death: Let’s Start in the Hospitals

Editor’s Note: In this article, Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety) with Arielle Bernstein Pinsof, MPP, Finn Partners and Gil Bashe, Managing Partner, Finn Partners Health Practice take the position that decreasing the opioid epidemic begins in the doctor’s office and healthcare facilities.

By Michael Wong, JD (Founder/Executive Director, Physician-Patient Alliance for Health & Safety) with Arielle Bernstein Pinsof, MPP, Finn Partners and Gil Bashe, Managing Partner, Finn Partners Health Practice

The tragedy of our national opioid epidemic has gripped hearts and headlines for months now with heartbreaking personal stories, images and statistics. But the truth is, not all overdose deaths are taking place on the streets — so while physicians and lawmakers race to find interventions that work on the front lines in our communities, shouldn’t we also take concrete steps to reduce opioid overdoses in the clinical setting — where they are highly preventable — where the full range of interventions are at hand?

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Clinicians’ Roles in the Opioid Epidemic

Editor’s note: In this week’s must reads, we look at articles that discuss the role of clinicians in the opioid epidemic.

Last week, we posted the article, “Is this the Right Question to Ask – Who’s to Blame for the Opioid Epidemic?” In that editorial, we applauded the efforts of the Massachusetts Attorney General in seeking to fine culpability and responsibility for the opioid epidemic. A lawsuit filed by the state of Massachusetts against Purdue Pharma alleges that the company, the Sackler family (which controls Purdue), and Purdue executives misled doctors and patients about the potential addictive qualities of opioids and, in particular, OxyContin, which Purdue manufactures.

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