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Optometrists’ Role in the Fight against Opioid Abuse


Increasingly, optometrists are playing a role in the fight against opioid abuse. 

Optometry Times suggests that these clinicians may be on the front lines in spotting the telltale signs of opioid addiction.

This article provides information for optometrists who might be the first physicians to notice signs of substance abuse in a patient. What can ODs do to help their addicted patients? Why is this becoming a more pressing problem than it has been in the past?

Addiction Treatment and “Better, Worse, or About the Same”

“The dilemma of handling patients with substance abuse problems, while seldom discussed in training and practices, is relevant to optometry’s role in society.”–Michael W. Ohlson, OD, FAAO, Optometry Times

While the Optometry Times suggests that ODs are not typically discussing opioid addiction as part of their clinical training, it is crucial that they consider themselves as a first line provider to stem the addiction crisis. The Review of Optometry cautions these physician providers to be on the lookout for drug-seeking behavior patterns. The article recommends that optometrists remain ever vigilant and cautious in their dispensing of opioid pain relievers to their patients.

Yet, because these providers are not trained in the clinical definition of the disease, they may lack an awareness of the disorder, which may lead to stigma. Optometry Times cites the 2012 report from The Center on Addiction and Substance Abuse at Columbia, which showed that physicians and mid-level providers do not receive training in addiction treatment, which means they often miss the clinical signs of the disorder. The report suggested that only one in 10 Americans who visit these providers receive the treatment they need and that the doctors' own lack of comfort with the disorder is causing missed opportunities to spot the disease.

According to Optometry Timessome of the clinical signs of substance use disorders to watch for include:

  • Mild tremors
  • The smell of alcohol or marijuana on the skin, hair, or clothes
  • Nasal irritation
  • Tachycardia
  • Injection marks
  • Jaundice
  • Sores or skin rashes
  • Lower temperature than normal
  • Chronic cough
  • Heart murmur
  • Edema in the legs or arms
  • Ataxia
  • Anxiety or paranoia
  • Anorexia
  • Labile blood pressure
  • Difficulty concentrating
  • Rhinorrhea
  • Diplopia
  • Dizziness
  • Severe dental decay
  • Slurred speech

There are a number of evidence-based tools designed to help optometrists (or other clinical providers) screen for substance use. The National Institute on Drug Abuse recommends the five key screening metrics, appropriately called, “The Five A’s:”

  • Ask as part of the screening process
  • Advise by recommending addiction treatment
  • Assess the patient’s desire to change his or her actions
  • Assist in any way possible
  • Arrange treatment or a referral to an addiction treatment facility

Other evidence-based screening tools include:

Addiction treatment

It is imperative that the optometrist avoid direct confrontation of these individuals, instead offering to help make an appointment with an addiction treatment center or provide other non-judgmental forms of clinical support.

Need somewhere to find support for your patients suffering from substance use disorders? Contact us to find out more about referring patients to our facilities.

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