The Opioid Crisis

As a critical care nurse, I’ve cared for many overdose victims. Seeing addiction from a healthcare provider’s point of view is eye-opening, and I can remember the faces of many of my patients who suffered from the torment of addiction.

Drug addiction is a vicious cycle of intoxication, binging, withdrawal, and craving that is persistent despite the negative outcomes of abusing substances1. It is a multifaceted chronic problem resulting from biological, environmental, genetic, and psychosocial factors2. Opioids are so addictive because they prompt the brain to release endorphins thereby reducing the ability to feel pain and simultaneously increasing euphoric feelings. These pleasant feelings are more intense than natural emotions and when the opioid wears off, the brain craves more of the manufactured feelings. Opioids change brain function, and the victim eventually develops tolerance requiring larger amounts to get the same effect. This leads to dependency and trying to stop taking the opioids leads to withdrawal symptoms3. Opioid use disorder (OUD) is complex and affects individuals regardless of their educational and socioeconomic backgrounds and is defined as long-term use of opioids resulting in impaired daily functioning2. OUD is dangerous because the victim needs to take high amounts of opioids which can cause respiratory depression, unconsciousness, and death3.

Patients who overdose and experience respiratory depression and an altered level of consciousness often end up in the ICU with numerous complications. Although respiratory depression accounts for most opioid-induced deaths, aspiration also significantly contributes to deaths in overdoses. Opioids slow gastric emptying, inhibit the cough reflex, and can cause emesis, all of which can lead to aspiration4. Aspiration causes an inflammatory reaction in the lungs leading to lung injury with reduced lung compliance resulting in hypoxemia and respiratory failure. Aspiration is an independent risk factor for developing acute respiratory distress syndrome (ARDS)5.

ARDS progresses rapidly as the lungs fill with fluid making it difficult to breathe thereby depriving organs of oxygen causing multisystem organ failure. The mortality rate for ARDS is high (about forty percent)6. The Proseva Trial showed that early placement of patients with ARDS in the prone position decreased mortality by fifty percent7.

The Pronova-O2TM Automated Prone Therapy System was developed with the input of critical care nurses to safely provide prone therapy to patients. Although we may not be able to single-handedly solve the opioid epidemic, we are eagerly partnering with healthcare providers to turn patients toward positive outcomes with our revolutionary equipment and educational platforms.