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Opioid use raises genuine concern in the United States today; everyone has an opinion about opioids and their use. Recently hospitalized patients have refused to take opioids after surgery for fear they would become addicted. In addition, some physicians refuse to prescribe opioids in their practice, even if their patients has been compliant on 1–2 hydrocodone/acetaminophen (Norco) a day for many years. The current political climate and the “war on opioids,” has caused the unintended result of tightening access for the legitimate patient rather than limiting illegal access according to interviews with patients. An Emergency Room (ER) nurse or physician cannot adequately assess the motivation of a patient who comes to the ER for the third or tenth or thirtieth time for the same problem asking for an opioid for their pain, while they are also caring for trauma patients. It is difficult to know if this is drug‐seeking behavior or a true pain exacerbation. Nurses can be at the forefront of policy design and protocol implementation throughout the various entry points of the health care system; this will enhance patient safety surrounding opioid use. National organizations have published guidelines and position papers to guide practice for primary care physicians, outpatient clinics, and hospitals to safeguard care. Opioid‐sparing efforts are the future of health care. [ABSTRACT FROM AUTHOR]

The Central Sensitization Inventory (CSI) is a diagnostic tool, which assists the clinicians in the identification of signs of central sensitization (CS). Psychosocial factors contribute to the development and maintenance of signs of CS. But the relationship with the CSI is unknown. The aim of this study is to investigate the convergent validity for the Dutch CSI with CSS, depression, anxiety, widespread pain, catastrophizing, and pain intensity. The second aim is to determine clinically relevant categories for the Dutch CSI. In this cross‐sectional study, patients completed multiple questionnaires. Bivariate correlations were calculated and the Kruskal–Wallis one‐way analysis of variance test was used. One‐hundred and ninety‐eighth patients were included. The CSI scores were strongly correlated with depression (rs = .67; p < .01), anxiety (rs = .65; p < .01), and CSS (rs = .51; p < .01). Moderate to strong relationships were found for the Widespread Pain Index (rs = .43; p < .01) and a low relationship with pain intensity (rs = .36; p < .01) and catastrophizing (rs = .39; p < .01). Four clinical relevant categories were identified: low 0–26 points, mild 27–39 points, moderate 40–52 points, and high 53+ points. This study provides a weak to strong association between the total score of the Dutch CSI and psychosocial factors, and presents clinically relevant categories for the Dutch CSI. [ABSTRACT FROM AUTHOR]

Medical interventions alone have been largely unsuccessful in treating and curing disorders characterized by chronic pain like central sensitivity syndromes (CSS; e.g., fibromyalgia, chronic migraine, temporomandibular disorders, irritable bowel syndrome). In this article, we discuss how a biopsychosocial perspective adds to understanding people's experiences with chronic pain. A biopsychosocial perspective examines how biological, psychological, social, and contextual factors work independently and jointly to influence the experience, maintenance, and exacerbation of CSS and their symptoms. We highlight several key psychological and social factors relevant to many people who live with CSS, while also emphasizing the heterogeneity in people's experiences, life courses, and symptoms. Furthermore, we emphasize that the psychological, social, and contextual factors that we include are best characterized as contributors to chronic pain experience rather than causes of it. [ABSTRACT FROM AUTHOR]

Deaths related to opioids have quadrupled since 1999, making it a top priority in health care. This article will provide an overview of the opioid crisis, focusing on the role that nurses play in addressing this crisis, with emphasis on assessment, early recognition, and prevention of opioid misuse. Systematic review of Medline, PubMed, and Google Scholar for articles relating to nurses’ role in pain management, education, and safe opioid use. Research suggests the incidence of ongoing, persistent pain is at an all‐time high (IOM Report, 2011, Relieving pain in America: A blueprint for transforming prevention, care, education, and research, The National Academies Press, Washington, DC), coincidentally the rate of opioid prescribing over the past 15 years has also reached an all‐time high (Prescription Opioid Overdose Data, 2017, https://www.cdc.gov/drugoverdose/data/overdose.html/). An “opioid crisis” was declared, calling for safer opioid prescribing (CDC Guideline for Prescribing, 2016, https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm/). Further research shows that nurses are educated and accomplished health care professionals (ASPMN, 2017, The core curriculum for pain management nursing, Elsevier, New York, NY; DEA Requirements, 2017, https://www.deadiversion.usdoj.gov/pubs/docs/dwp_buprenorphine.htm/; Ray & Behr, Clinical Nurse Specialist, 31, 2017, 115; St. Marie, Pain Management Nursing, 17, 2016, 311), at the forefront of monitoring for addiction and opioid misuse. Nurses contribute greatly to enhanced pain assessment and education to patients, families, and their peers. With the current opioid crisis, nurses have taken on the added responsibility of monitoring for potential opioid abuse, safety, and signs of addiction in their patients. [ABSTRACT FROM AUTHOR]