Motivational Interviewing Combats Opioid Abuse


It is safe to say that prescription opioid addiction, like any substance with the potential for addiction, does not discriminate. The nation has seen opioids take the lives of thousands of people for over a decade, yet patients continue to be prescribed the drugs at unprecedented levels. Part of the problem is that pain needs to be managed, and the drugs that work best happen to be highly addictive. If misused, opioids like oxycodone or hydrocodone can be life threatening.

Unlike the typical stereotypes that often accompany heroin addiction, prescription opioid addicts are often: professionals, mothers, students, productive members of society. Addiction typically stems from an injury that required the use of painkillers. While most people can use a prescription opioid until the pain goes away, there is a large number people who become dependent on such drugs and what was once a method of pain management can quickly become an addiction.

Faced with a prescription opioid addiction epidemic, federal agencies and lawmakers have made it more difficult for prescription opioids to be acquired and abused. In turn, people dependent on the drugs have been forced to look to the street, many of which opt for heroin as a cheaper and stronger opioid.

The American Society of Addiction Medicine (ASAM) reports that prescription opioids:

  • Are abused by 1.9 million Americans.
  • Cause nearly two deaths every hour from overdose or respiratory depression.
  • Almost 75 percent of opioid addiction patients switch to heroin.

The nation’s opioid epidemic happens to coincide with the “Baby Boomers” meeting old age or on the cusp. Naturally, the generation is requiring more frequent medical attention, many of which require pain management. It is believed that more than half of patients being treated for chronic pain misuse their medication at some time, ScienceDaily reports. Fortunately, new research suggests that motivational interviewing (MI), a form of behavioral counseling developed to treat alcohol abuse, may be effective in fighting prescription opioid abuse among aging adults.

“Older adults are at high risk for complications resulting from prescription opioid misuse,” says Chang, PhD, RN, associate professor and interim associate dean for research and scholarship in the University of Buffalo School of Nursing. “As the baby boomer generation ages and more patients are prescribed opioids, abuse is likely to become an even greater problem.”

MI promotes a patient’s desire to change behaviors that may be problematic by:

  • Expressing empathy for what they are going through.
  • Using non-confrontational dialogue
  • Creating a divergence between actual and desired behavior.

Patients 50 years of age and older who had chronic pain and were rated at risk for opioid misuse were examined by researchers, according to the article. The participants underwent MI for one month with counselors, and later received a one month follow-up test. Participants reported an increase in confidence, self-efficacy and motivation to change behavior, and a decline in depression, anxiety and the intensity of chronic pain.

“The Effect of Motivational Interviewing on Prescription Opioid Adherence Among Older Adults With Chronic Pain,” was published in a recent issue of Perspectives in Psychiatric Care.

People with Chronic Pain Find It Difficult to Get Their Medication


Prescription drug abuse continues to plague Americans in all 50 states, and effective measures to combat the problem appear to be a double edged sword. On the one hand: prescription drug monitoring programs and more cautious prescribing practices have served to reduce abuse and/or overdoses. On the other hand: effective harm reduction policies are making it harder for those with legitimate chronic pain to get the medications they need.

Florida was once considered to be the easiest place to acquire prescription opioids, such as OxyContin ® (oxycodone), due to a plethora of “pill mills” (pain management clinics that will dispense narcotics onsite) and overprescribing doctors. In an attempt to reverse the trend, the Drug Enforcement Administration (DEA) came down on the state with a firm hand, shutting down more than 250 pill mills, PBS NewsHour reports.

The DEA went after doctors and pharmacies that were, what the agency considered, writing and dispensing too many pills. The nationwide pharmacies, CVS and Walgreens, paid civil penalties for record-keeping violations of the Controlled Substances Act. Walgreens paid an $80 million penalty and CVS paid an $11 million penalty, according to the article.

The result, pharmacies were warned to not cross DEA dispensing ceilings, or face penalties. In Florida, an independent pharmacy owner in Jacksonville, Bill Napier, says the amount of drugs he needs to supply his clients is not being provided by drug wholesalers who supply his store. What’s more, the DEA approached Napier last year regarding the amount narcotics he dispensed.

“They showed me a number, and they said that if I wasn’t closer to the state average, they would come back. So I got pretty close to the state average,” he said. “I turn away sometimes 20 people a day.” 

The acting deputy administrator of the DEA, Jack Riley, claims that his agency is not to blame for the medication rationing, according to the article.

“I’m not a doctor. We do not practice medicine. We’re not pharmacists. We obviously don’t get involved in that,” he said. “What we do do is make sure the people that have the licenses are as educated as possible as to what we’re seeing, and that they can make informed decisions as they do dispense.”


If you are currently struggling with opioids and are in need of help, please do not hesitate to contact Harmony Foundation to begin the journey of recovery. Harmony is a state-of-the-art, affordable, residential addiction treatment program located in the Rocky Mountains.

Generic Vicodin Prescibed More Than Any Other Drug

In the United States, pain management is an important need, as well as a major problem. Patients complaining of pain are entitled to appropriate medications for treatment. Unfortunately, far too often medications, such as OxyContin ® (oxycodone) and Vicodin ® (hydrocodone), are misused and abused which ultimately can lead to addiction. Chronic over prescribing of opioid medications and gaps in screening, has led to a prescription drug epidemic in America.

In 2013, more Medicare beneficiaries received a prescription for generic Vicodin ®, known as hydrocodone acetaminophen, than any other prescription drug, The Wall Street Journal reports. In the same year, nearly two million Americans either abused or were dependent on opioids, according to the Centers for Disease Control and Prevention.

“It’s striking that the drug prescribed to the most beneficiaries is a narcotic painkiller that can be addictive,” said Walid Gellad, an associate professor at the University of Pittsburgh School of Medicine.

The findings come from an analysis of Medicare’s prescription drug program, according to the article. The data indicated that some doctors prescribe the drug much more often than others, and a group of about 200 doctors gave the drug to more than half of the beneficiaries to whom they prescribed. Despite hydrocodone’s high potential for dependence, about 691,000 providers prescribed the drug in 2013.

The data showed that approximately 8.09 million Medicare beneficiaries were prescribed hydrocodone acetaminophen. Interestingly, the drug prescribed the most after generic Vicodin ® was the cholesterol drug simvastatin, with 7.03 million prescriptions.

Pain management is not an easy task, partly due to the fact that pain is subjective. However, it is clear that doctors should turn to prescription opioids as a last resort. Simply handing out Vicodin ® for minor pain complaints only fuels the prescription drug epidemic plaguing America.

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