NP Education Regarding Opioid Dependence and Withdraw in Advanced Health Assessment

Background: Increase in therapeutic and non-therapeutic uses of opioids in the United States and worldwide is a growing public health concern. Unintended consequences of the trend include opioid abuse, dependence and addiction. Regarding opioids, providers often have inadequate training in how to assess and differentiate opioid dependence, abuse and withdraw. Addictions cross all disciplines and populations and should be provided as core content for all NP students.

Methods: The School of Nursing developed one required advanced health assessment across the lifespan course for all DNP APRN students. Within the Neuromuscular content for Advanced Health Assessment a module was developed to provide topical content, standardized assessment tools and additional resources for students. The initial module was provided in a didactic format but would easily lend itself to online or distance learning. Within the module topics presented were: Why do we care?, Specific red flags and questions to ask during the health history, definitions of opioid dependence and withdraw, skills to perform a physical exam to differentiate opioid intoxication, abuse, overdose and withdraw. The Addiction Severity Index (ASI) was provided as a free, easy to use tool for students. 

Outcome: The immediate outcome was students remained engaged and responded appropriately to content review and questions at the end of the module. An outcome measure in-progress is a post-test questionnaire provided to students regarding retention of addictions content and a survey about their satisfaction in the quality and relevance of the information presented. The goal is to provide core content about addictions and for NP students to have baseline knowledge of assessing opioid dependence and withdraw.

Recommendations: As opioid misuse rises in the general population, it is vital that NPs have the skills to properly assess patients and help patients achieve positive outcomes. Providing addictions content in Advanced Health Assessment provides foundational knowledge and skills vital to successful practice. Additional recommendations include provide the module content completely online, having a pre-test/post-test format to better evaluate student learning and to incorporate a standardized patient afflicted with addiction to provide experiential learning for students in a safe environment.