We hear a lot of buzz about the opioid epidemic, and rightfully so; the public health crisis caused by the misuse of prescription opioids has caused countless tragedies. We have seen its devastating effects on the news, in our communities, and in the healthcare setting. Critical care nurses know just how dangerous patient misuse of these substances can be. But what about when the substance being misused is a readily available over-the-counter (OTC) product found in such common places as grocery stores?

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Alcohol is not listed in the Controlled Substance Act and is not considered a controlled substance by the Drug Enforcement Administration, but for some users, especially those with a family history of alcohol use disorder, it can be addictive, have a high potential for misuse, and be the source of many health problems.1Caring for hospitalized patients with alcohol withdrawal syndrome (p. 18) outlines how frontline clinicians can prevent, recognize, and help treat patients with this potentially life-threatening disorder.

Acetaminophen is a widely available and easily obtained drug that, when misused, can have serious health consequences. This low-cost drug is typically a safe and effective analgesic and antipyretic agent when taken in the recommended dosage, but an overdose, whether accidental or intentional, can lead to hepatotoxicity and even liver failure. Acute acetaminophen toxicity in adults (p. 10) reviews what critical care nurses need to know to promptly recognize acetaminophen toxicity and begin treatment.

Also in this issue, Update: Guidelines for the management of pediatric severe traumatic brain injury (p. 32) summarizes the 2019 update to the guidelines last published in 2012. Highlights of the update include changes regarding patient monitoring, thresholds, and treatments.

Be sure to also check out Reducing compassion fatigue with self-care and mindfulness (p. 38). This article outlines a study in which participants gained increased compassion satisfaction through mindfulness and meditation. Could these techniques be implemented on your unit?

Remember that although the misuse of commonly encountered substances, like alcohol and acetaminophen, receives less media attention amid the backdrop of the opioid epidemic, this improper substance use can still lead to serious health consequences for patients. Critical care nurses can help minimize the damage done by such OTC products by promptly screening patients for substance misuse and drug toxicity to initiate prompt treatment when required.

Haley K. McKinney, MBA

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Associate Editor Nursing2019 Critical Care Health Learning, Research & Practice Wolters Kluwer Philadelphia, PA.

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