Nursing Ethical Issues: Chronic Migraine Treatment through Opiates and Opioid Medications

Running Head: NURSING ETHICAL ISSUES: CHRONIC MIGRAINE TREATMENT
THROUGH OPIATES AND OPIOID MEDICATIONS
1
Nursing Ethical Issues: Chronic Migraine Treatment through Opiates and Opioid Medications
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NURSING ETHICAL ISSUES: CHRONIC MIGRAINE TREATMENT THROUGH OPIATES
AND OPIOID MEDICATIONS 2
Nursing Ethical Issues: Chronic Migraine Treatment through Opiates and Opioid Medications
For a very long time now, opioids have been used across the globe as very effective pain
treatment and management medications (Buse et al., 2012). The usage of opiates and opioid
medications in the management of pain resulting from prolonged medical illnesses such as a
migraine is by and large regarded as the standard of cure of the same globally. However, at the
same time, the continued usage of opioids for pain management has elicited worldwide
controversies leaving most healthcare practitioners with ethical dilemmas on how they are
supposed to treat and manage their patients using the same. While scientific research has
extensively proven that opiates and opioid medications such as Tramadol to be overly good in
the management of chronic migraine, issues related to safety, abuse liability, effectiveness have
rocked the medical profession (Maumus, 2015). Some opponents have openly advocated for its
restriction while its proponents need it to receive a greater endorsement. This paper will
extrapolate on the ethical issues surrounding the use of opiates and opioid medications in the
management of chronic migraine besides reflecting on how this may influence my professional
nursing practice.
The globe has undergone shifting interfaces of legitimizing opioids and reverting
legitimization for fears of opening up doors for abuse and addiction from the same. These
interfaces have advanced pain treatment dilemmas across the clinical community resulting in
great uncertainties concerning the appropriate role of these drugs in chronic migraine
management and treatment. Indeed, opioids undeniably play a critical role of easing patients’
pain (Alemdar, Pekdemir, & Selekler, 2007). This is especially the case when over the counter

NURSING ETHICAL ISSUES: CHRONIC MIGRAINE TREATMENT THROUGH OPIATES
AND OPIOID MEDICATIONS 3
prescription of opiate-based medications are allowed in the management and treatment of
migraines. In the past, deserving instances when these drugs could have been used to treat pain
emanating from chronic migraine, cancer, general acute pain, and the end-of-life pain have
indeed been denied usage due to addition concerns (Stein, 2013).
Chronic migraine is one of the deserving medical conditions for opiates and opioid
medications according to the American Center for Disease and Control (CDC) guidelines
(Dowell, Haegerich, & Chou, 2016). This assertion is in accordance with the International
Headache Society (2018) description of episodes of chronic migraine. The body describes
chronic migraine as instances when a person experiences persistent headache for a period of
more than 15 days in a month over a period of 3 consecutive months with at least 8 days of acute
migraine pain. The World Health Organization (WHO) has indeed appreciated the impacts and
implications of chronic migraine globally categorizing it at a similar level as dementia and acute
psychosis (Huang, et al., 2015).
Following these observations, in as much as the usage of opiates and opioid medications
in chronic migraine treatment is bound to tag along with abuse and addiction challenges, its
usage is indeed a relief to chronic migraine patients. Reuben, et al., (2015) posit that concerns
that addiction is a frequent result of opioids may more or less be attributed to confusion over the
very terminology and failing to appreciate that chronic pain and addiction are actually of
multifactorial etiology. Moreover, ethical dilemmas in its usage may emanate from the failure to
accurately define the distinction between physical dependence and addiction. Most opioids
administered patients with chronic migraine pain have been established to act differently from
those who abuse the same even though pain and addiction are not mutually exclusive.