To analyze current policies aimed at addressing the opioid crisis, describe examples of the crisis, and suggest a few options to help solve the problem to the community. A stakeholder group of people in the community, including local policymakers, leaders, and concerned citizens. The United States of America is experiencing a severe crisis of opioid abuse. In 2019 alone, opioids took the lives of 50,000 Americans, and the economic burden from the problem is about $78.5 billion a year (National Institute on Drug Abuse, 2021). This issue concerns many stakeholders, from society and medical staff to individual policymakers and representatives of various structures like the Center for Disease Control and Prevention (CDC) or the National Institute on Drug Abuse (NIDA). Although different structures and organizations are making many efforts to stop the crisis, communities can also significantly contribute to solving the problem. Everyone present here can learn and do more than now, and then together community will save more lives. Today, I will present a description and analysis of policies against the opioid crisis, consider examples of the crisis, and propose several measures and actions that communities can take in this fight.
It is important to say that there are several main directions for political action in the fight against the opioid crisis. Key actors such as the U.S. Department of Health and Human Services (HHS) and National Institutes of Health (NIH) prioritize the following:
Improved access to treatment, prevention, and recovery services;
Promote the availability and use of drugs that prevent overdoses;
Healthcare surveillance for transparent reporting and collection of data to better understand the situation;
Support research in understanding pain and safe methods of its management;
Promoting different pain reduction methods (Collins, 2017; NIDA, 2021).
Most organizations involved in the fight against the crisis are focused on the mentioned goals. Organizations include Substance Abuse and Mental Health Services Administration (SAMHSA), CDC, Food and Drug Administration (FDA), and other entities. Some organizations add their own goals; for instance, the Healthcare Fraud Prevention Partnership (HFPP) also seeks to identify and stop fraud and other dishonest opioid activities (Healthcare Fraud Prevention Partnership, 2017). Programs in the States, in turn, monitor drug prescriptions and the work of pain management specialists (CDC, 2019). Thus, all measures aim to reduce the chances of opioid abuse and maintain the nations health.
The analysis aims to understand and evaluate policy effectiveness to provide informed advice for new policy decisions and actions. Analyzing the existing medical policy, it is worth paying attention to its successes. Some successes include:
State programs in Ohio, Kentucky, Florida, New York, Tennessee, and other states, have helped reduce opioid abuse and mortality rates (CDC, 2019);
SAMHSA provides professional training grants and Medication-Assisted Treatment (MAT) for vulnerable populations;
The CDC conducts and supports studies that bring new knowledge on risk factors and other influential aspects and offer solutions.
However, it is worth noting that the problem continues to exist. In particular, policies may have unintended consequences of using drugs other than opioids due to insufficient attention to the causes of abuse (Lee et al., 2021). Therefore, the fight against opioids should be comprehensive and include measures to improve social conditions and community support.
Let us consider some examples of the manifestation of the opioid crisis, which may be significant for policies to combat it. Examples:
The opioid crisis began in the late 20th century when pharmaceutical companies convinced society that opioid-based painkillers would not be addictive and were prescribed in large quantities (NIDA, 2021);
About 21-29% of patients with prescriptions for opioids due to chronic pain misuse them, and 4-6% of abusers later abuse heroin (NIDA, 2021).
8-12% of those taking prescribed opioids suffer from opioid use disorders (NIDA, 2021);
Risk factors for developing opioid addiction include improper or prolonged drug use, poverty, unemployment, personal or family history of misuse, risk behavior, contact with high-risk individuals, stress, and other causes (Mayo Clinic Staff, 2018).
Understanding the risks, causes, and influencers for the opioid crisis, one can suggest several measures that communities can take. Proposed measures include:
Collaboration within the community to raise awareness about the dangers of opioids, policies to combat the crisis, the possibilities of intervention, and the provision of assistance for overdoses;
Creating an organization or public coalition that can help people with addiction, particularly through referral to treatment, providing drugs that prevent overdoses, and other measures;
The creation of support groups in various areas help those who suffer from addiction, help those who suffer from chronic pain and similar issues connected with risk factors.
The evaluation criteria for proposed policy options include:
Community awareness of the dangers of opioids, laws related to the crisis, and peoples ability to take action and provide assistance;
Help members of the community that suffer from opioid use disorders;
Availability of overdose prevention drugs and treatment to those members of the community who need them;
Activities of support groups aimed at mitigating risk factors and social support.
In summary, it is essential to note that the opioid crisis poses a significant danger to Americans. It began after erroneous information that opioid-based drugs are not addictive spread. However, the use of such drugs carries a high risk of developing addiction and other disorders associated with opioid use. Various organizations and public bodies have taken many actions to combat the crisis. Key measures are drug prescription control aimed at reducing opioid use, finding other pain management methods, and similar efforts. Societies can be critical participants in the struggle by providing information, helping those who suffer from addiction or severe pain, and taking other measures. Thus, everyone present here can take some actions and help save lives.
References
Centers for Disease Control and Prevention. (2019). State successes. CDC Website. Web.
In most patients, some types of drugs function better as expected, but the same cannot be said about other patients who experience advance side effects such as toxic effects, even with minimal doses. The reason for such adverse outcomes, in some patients, has been attributed to genetic. This essay defines pharmacogenomic testing, demonstrates how it would change prescription of opioid treatments and potential benefits to medical marijuana testing.
According to Kitzmiller et al., pharmacogenomics is the study of how genetic factors relate to interindividual variability of drug response (243). It has been established that significant minorities of the population have genetic variants referred to as polymorphisms, which influence their reactions to different drugs (Kitzmiller et al. 243). Studies in genetic and comprehension of drug variability have led to increased pharmacogenomic testing in the last decade. As such, several polymorphisms have been tested and results are currently available.
Specifically for opioids and pain management, researchers have demonstrated that people with elevated levels of phenotype activities may need increased doses of opioids compared to patients with low phenotype activities (Tennant and Hocum 3). Based on such results, the researchers noted that the most appropriate mechanism involved high-activity catechol-o methyltransferase (COMT) outcomes, which led to a decreased response of the neurotransmitter and, thus, low signal transduction when painful stimuli occurred, causing higher pain intensity (Tennant and Hocum 3). In addition, these studies have also established that people with such conditions also reflect reduced downstream opioid receptor density (Tennant and Hocum 3). When such patients suffer pain, it could be extremely severe and, therefore, higher doses of opioid are normally needed.
Medical marijuana is known to management chronic pain conditions such as spinal cord insult, fibromyalgia, and neuropathic pain among others (Stanz 1). In this regard, pharmacogenomic testing can significantly transforms prescription of medical marijuana to patients. For instance, in the recent years, a medical marijuana-testing laboratory has developed a technology to predict possible outcomes associated with medical marijuana several strains through the use scientific data and reviews obtained from social networking Web site (Stanz 1). Consequently, patients can personally choose medical marijuana based on ratings for sleep aid, pain relief, nausea treatment and anxiety, appetite stimulation, and mood modification (Stanz 1). These new technologies open more avenues for pharmacogenomic testing to enhance outcomes. Thus, medical marijuana with multiple applications can be effectively used based on pharmacogenomic testing results.
Obviously, pharmacogenomic testing will transform the practice of medicine and prescription. It has been noted that the use of pharmacogenomic testing is now extending to some widely prescribed medicine and other drugs used in primary care. It is imperative to note that the mass application of individualized medicine is not yet developed while expert committees have not given their opinions for most drugs, including medical marijuana.
With the information of patients genetic conditions, physicians could determine possible reactions of patients to specific drugs, including medicine marijuana. As such, they are most likely to lead to enhanced efficacy, reduced cases of advance outcomes related to drugs, and lower costs of treatment. Thus, potential impacts of pharmacogenomic testing are substantial because many drugs with adverse outcomes are subjected to chemical activities involving polymorphic enzymes. Adverse, unexpected reactions of drugs remain risky to public health. Hence, morbidity and mortality associated with adverse drug reactions, including medical marijuana can be curbed through pharmacogenomic testing.
References
Kitzmiller, Joseph P. David K. Groen, Mitch A. Phelps and Wolfgang Sadee. Pharmacogenomic testing: Relevance in medical practice. Cleveland Clinic Journal of Medicine 78.4 (2011): 243257. Print.
Stanz, Angel. Medical Marijuana Testing Lab Claims To Forecast Personalized Cannabis Treatment. Laboratory Network. 2011. Web.
Tennant, Forest and Brian Hocum. Pharmacogenetics and Pain Management. Practical Pain Management 15.7 (2015): 1-3. Print.
The United States is facing a serious social problem in the name of the opioid epidemic. It is a challenge that impacts millions of people, especially teenage children. A significant population of young American people is at risk. The good news is that the opioid problem and other related addictions are preventable if the right preventive models are employed. Throughout this course, different preventive models and their effectiveness have been explored. Specifically, primary, secondary, and tertiary intervention methods have been emphasized as the best approaches to dealing with social concerns at a broad level. Based on what I have learned, I strongly believe combining the three prevention models would be effective in my school or community.
The prevention models work perfectly well since they target different behaviors and groups. As a result, the strategy or programs ensures that everyone in the community is served. The primary prevention level majorly aims to create awareness about the social problem and how to avoid it (Capuzzi & Stauffer, 2014). In the case of the opioid pandemic, the primary stage educates the masses on the causes and effects of misusing opioid drugs. Although the target population is young people, other members of society can also benefit from the knowledge. Thus, the goal of primary prevention is to control the problem before it harms people by creating awareness.
On the contrary, secondary prevention targets individuals at risk through exposure to social problems. Although the approach educates the targeted people, the main purpose is to enhance change in behaviors (Capuzzi & Stauffer, 2014). For instance, secondary prevention helps in educating those youths who are experimenting with drugs. Thus, it enables the affected individuals to abandon the behavior before it gets to the addiction level. Lastly, the tertiary prevention approach focuses on treating the affected individuals (Capuzzi & Stauffer, 2014). An excellent example is young people already addicted to drugs like opioids. The aim is to lessen the impact of the addiction and help the persons recover from the problem. Therefore, the prevention model would be effective in my school or community since it caters to everyone, including people not yet affected and those already struggling with addiction.
Reference
Capuzzi, D., & Stauffer, M. D. (2014). Foundations of addictions counseling (3rd ed.). Pearson.
Prescription opioids are medically utilized to treat chronic and acute pain. Opioid drugs are vital in offering treatment if employed as prescribed. They are drugs found in the opium poppy plant and work in the brain when taken to produce a variety of effects. The drugs pose severe risks to their users, including death, overdoses, and addiction. Also known as painkillers, they are often prescribed to individuals with cancer and those suffering from moderate to severe pain due to an injury or surgery. Some common forms of this drug include tapentadol, methadone, morphine, fentanyl, and hydromorphone. Using the medicine has its related side effects even if utilized correctly. Possible side effects include constipation, physical dependence, depression, and confusion. It is highly associated with opioid deaths in America due to overdose. Prescription opioids are widely resorted to relieving pain; they may get misused, resulting in severe health conditions like overdose leading to death.
I picked the topic as it incorporates one of the most commonly misused drugs. It is frequently abused worldwide, becoming a health concern due to increased mortality and morbidity. In the United States of America, the number of deaths related to prescription opioids has quadrupled in the last ten years (Thomas et al., 2022). Its use globally has increased among adults averaging 0.7 percent, which accounts for about 33 million users (Thomas et al., 2022). Death cases resulting from opioid overdose average 91 individuals each day, with over 1000 people getting treatment for prescription opioid misuse in the emergency department (Ignaszewski, 2021). The severe health concern does affect not only men but also women. In recent research by Thomas et al. (2022), the number of women exposed to abuse has significantly increased compared to men. Women are more likely to be victims as they most likely get prescriptions for the drug.
Prescription opioids are utilized to help treat pain ranging from moderate to severe. Some of the drugs treat diarrhea and coughing as they can cause the body to relax. They relieve pain by binding to and activating the opioid receptors in the spinal cord, the brain, and many other areas (Harries et al., 2018). After attaching, they block pain signals sent from the brain to the body. They consequently release a lot of dopamine throughout the body. Fentanyl, a synthetic opioid pain reliever, is more potent than other drugs (Volkow et al., 2019). It is used to treat more severe pain cases like advanced cancer pain. The drug is offered to individuals that have undergone surgeries to reduce the pain experienced before and after. Morphine is a common pain reliever that treats severe pain hence being categorized under the class identified as opioid analgesics.
Drugs are getting abused when they are consumed for non-medical purposes. Prescription opioids mostly misused include oxycodone, codeine, morphine, and hydrocodone (Thomas et al., 2022). The drugs are only safe when taken for pain relief within a short period as directed by the doctor. Its misuse and abuse are experienced through taking medicine for wrong purposes other than the required. The medication is also often adopted for the effect of one getting high, which is incorrect. When one takes another persons prescription, this is misuse and abuse of the drug. Abuse of these drugs can occur knowingly or unknowingly when one accidentally overdoses (Thomas et al., 2022). The youths are the most vulnerable population that engages in the illegal use of drugs. Frequent drug usage results in dependence, making it difficult to stay without taking it; prescribed opioids are highly addictive.
The abuse of prescription opioids has led to numerous effects within society. Apart from addiction, drug abuse has resulted in many deaths. Young adults and children are at a higher risk of becoming addicted when exposed to the drug, unlike older individuals (Ignaszewski, 2021). Children born from mothers who abuse drug experience withdrawal syndrome. Family and personal distress are experienced by the users causing discomfort. The community is further affected by the loss of future productivity and additional healthcare costs, which become a burden. The abuse also results in increased admissions to substance abuse programs. In America, admissions between 2002 and 2010 increased from ninety-one thousand to 259 thousand (Harries et al., 2018). Additional healthcare issues like psychosocial dysfunctions, withdrawal, and apathy get experienced among the users.
A certified medical practitioner conducts opioid abuse treatment and decides on the most effective method. The three main medications employed in treating opioid use disorders are naltrexone, methadone, and buprenorphine (Volkow et al., 2019). One common antidote used to reverse the effects of an opioid is naloxone. It attaches itself to the opioid receptors blocking the resultant effects; it is only effective if administered on time. Behavioral therapy and medication are included in the recovery processes of all opioid abusers, although not all are compulsory. The four stages of treatment practiced are treatment initiation, early abstinence, maintaining abstinence, and advanced recovery. Social programs play a critical role in the treatment as they provide the interventions, resources, and activities that help a recovering person from relapsing.
The aftercare involves the recovery process of the drug abusers. Addiction is a medical concern, and treatment can help the victim to recover. The first step consists of the prevention of overdose death and seeking treatment. Treatment occurs in different settings depending on the victims individual needs, as it may take various forms and timelines (Volkow et al., 2019). Proper aftercare involves therapy and medications to facilitate an appropriate recovery. It may include sober living, outpatient care, 12-step meetings, and counseling. Adopting a good recovery plan is critical; drugs increase the chances of success as they help normalize brain chemistry (Volkow et al., 2019). It helps anticipate potential future challenges and enables the development of appropriate solutions. Family members and friends can participate in the aftercare treatment offering support to the victims. The move tends to encourage healthy benefits as one feels valued and loved.
Prescription opioids are highly acquired and handled by individuals of all ages. The drug is highly addictive; it is misused and abused, causing one of the leading health concerns globally. Drug abuse has led to many deaths and left some users critically ill. Its primary purpose is to help in treating mild and severe pain. When utilized for purposes other than the one it is meant for, that is abuse. The drug being misused has led to severe effects not only con individuals but also on society. Treating the addiction is easy and possible under medical supervision. The use of antidotes and other medication splay a critical role in the recovery process. Appropriate aftercare includes attending behavioral therapies and involving family and friends in the recovery journey.
Agencies that Regulate and Oversee APRN Prescribing in New Mexico
New Mexico Board of Nursing
The Board of Nursing in New Mexico plays a fundamental role in regulating the prescriptive authority or mandate for the Advanced-Practice-Nurses (APRNs). The above-mentioned organization typically evaluates the credentials required for the APRNs to undertake the role of prescribing opioid and non-opioid drugs and substances ( APRN endorsement, 2020). At the same time, the Board of Nursing in New Mexico carries out assessments of the APRNs capacity to understand the practice of pharmacology, clinical diagnosis, physical examinations, and pharmacotherapeutics ( APRN endorsement, 2020). The motive behind the nursing boards actions in the state of New Mexico premises on the promotion of safety and health needs of the citizens or patients.
New Mexico Nurse Practitioner Council
The Nurse Practitioner Council registered in the State of New Mexico is keen on overseeing their members professional requirements while ensuring that the actions of the APRNs are in line with the set guidelines for the prescriptive authority outlined in the state ( APRN endorsement, 2020). Understandably, it monitors the APRNs roles and offers guidance on effective compliance and safety practice when handling prescriptions for patients. The need for physical assessments of the patients by the APRNs is a crucial aspect of the oversight on prescriptive authority granted to their members to ensure that the risk profile associated with substance overdoses and abuse reduces significantly.
New Mexico Association of Nurse Anesthetics
The Nurse Anesthetics Association in New Mexico is a strategic player in regulating the prescribing authority granted to the members of the professional association body. The association focuses on the adherence to the best practice given to the APRNs due to the sensitivity involved in the prescription of controlled and uncontrolled substances in the state of New Mexico. The body regulates the anesthetics professional mandate within various medical facilities and drug outlets in the state ( APRN endorsements, 2020). The checks and verification on the education requirements set for the licensure of the prescriptive authority accorded to the APRNs are at the heart of the Nurse Anesthetics Associations actions and procedures in the state of New Mexico.
America Midwifery Certification Board (AMCB)
In essence, the practicing Certified-Nurse-Midwives (CNMs) in the state of New Mexico operate under the recommendation and regulation of the AMCB. The AMCB has networks that touch on all strategic states in the United States of America. For their prescriptive roles in the course of their practice, the board requires that the CNMs should uphold all the set guidelines for the prescription of substances in a bid to limit the risks and fatalities that may result from overdoses, abuse, and inappropriate prescription to patients ( APRN endorsement, 2020). The AMCB in New Mexico oversees the qualification of the CNMs and their appropriateness in taking up the roles associated with prescriptive authority according to the regulations established by the state.
American Nurses Credentialing Center
Without a doubt, the Credentialling Center in charge of monitoring and ascertaining American nurses educational qualifications, helps in the regulation of the prescriptive capacities of their members in the state of New Mexico. The academic requirements established for the APRNs in the State of New Mexico undergo evaluations and ascertainment by the credentialing center. The center guides members on the high-priority qualifications- to facilitate the issuance of prescriptive authority especially in pharmacology, clinical diagnosis, and pharmacotherapeutics ( APRN endorsement, 2020). Similarly, the credentialing center ensures that the members certification and academic qualifications are accurate, legitimate, and reliable; hence, the entity helps to certify and regulate the prescribing role granted to the APRNs in New Mexico.
American Association of Nurse Practitioners
The Nurse Practitioner Association in the United States contributes significantly to the management of APRNs prescribing role in the state of New Mexico. Understandably, the association guides the members on the appropriate academic and professional programs undertaken for the smooth certification process, given the prescriptive authority of the APRNs in the state of New Mexico. Further, the association helps in the oversight role in regulating the prescribing mandate of the members by ascertaining their worthiness and qualifications towards prescriptive authority ( APRN endorsement, 2020). Again, the body empowers its members and educates them on the appropriate methods and approaches applied in prescription controlled and uncontrolled substances in the State of New Mexico.
Educational Requirements for Prescribing as an APRN
APRNs (Advanced-Practice-Nurses) are granted prescriptive authority based on the outlined state requirements to ensure that the health and safety concerns are satisfactory. Indeed, the independent control for prescription allows the APRNs to carry out prescriptive roles on the controlled and legend or prescription drugs within the state ( Advanced practice nurse requirements, n.d.). Further, it enables the APRN to handle medical goods, supplies, and equipment required in the process of prescription. An NP (Nurse-Practitioner) and a NA (Nurse-Anesthesiologist) must clock 400 hours regarding preceptorship for them to be granted prescriptive authority in New Mexico and other states ( Advanced practice nurse requirements, n.d.). Additionally, the requirement is pardonable if the NP and NA have undergone 400 hours of practical experience in a prescriptive environment.
For clinical nurses (CN), the educational requirement established for them requires that they undertake advanced coursework that is easily verifiable in pharmacology, pathophysiology, and assessment. Again, the CN must provide proof of work experience, which may substitute for a university-oriented preceptorship under supervision ( Advanced practice nurse requirements, n.d.). Agreeably, the set licensing authority mandated to oversee prescriptive authority may accept 45-hours given continuing education related to advanced coursework in the area of pharmacology. In this regard, a CN who lacks verifiable work experience of 400 hours may undergo authorization regarding preceptorship when he or she completes the relevant advanced coursework set for the license ( Advanced practice nurse requirements, n.d.). The specialist CNs who lack the required work experience in an environment of prescriptive capacity require the licensing authority to have undertaken advanced coursework in pharmacology.
APRNs must clock 45 hours of relevant advanced pharmacology and requisite training in clinical management established for drug therapy. Indeed, a 6-month long program on work experience under the supervision of a physician is required, coupled with advanced coursework in the field of pharmacology ( Advanced practice nurse requirements, n.d.). Again, for APRNs to have the capacity to prescribe Schedule II- oriented substances (controlled), they are required to undertake a complete educational program on the prescription of Schedule II substances that are held. Three-semester-long course work in advanced pathophysiology and pharmacology coupled with training on physical assessment needs the APRNs to get certification in prescriptive authority. Besides, APRNs need to undertake coursework in pharmacotherapeutics, pharmacology, and health assessment ( Advanced practice nurse requirements, n.d.). The training helps them develop the capacity to handle patient needs and reduce the risks associated with prescription controlled substances in the United States.
Further coursework in advanced management and diagnosis of patient problems within a clinical specialty environment is a prerequisite. Understandably, the prescriptive authority accorded to the APRNs is set for renewal on a biennial basis with evaluations on the requirements based on the time of service ( Advanced practice nurse requirements, n.d.). For APRNs who have not been in clinical practice for more than 24 months, the licensing authority mandates them to undertake 24 hours of advanced continuous education (CE) ( Advanced practice nurse requirements, n.d.). The CE division is set for at least 12 hours in the field of clinical management and another 12 hours in the area of pharmacotherapeutics.
Without a doubt, the licensing process or program for APRNs is critical for the achievement of uniformity given the regulatory requirements established for the prescriptive authority in consideration of non-opioid and opioid-oriented substances ( Advanced practice nurse requirements, n.d.). Further, the educational needs in advanced pharmacology, physical assessment coupled with diagnosis, and pharmacotherapeutics enable the APRNs to mitigate against the safety and health risks associated with an inappropriate prescription for controlled and non-controlled substances ( Advanced practice nurse requirements, n.d.). Moreover, the physical assessment and set diagnosis help the APRNs understand the medical history of the patients and their state of physical health before offering any prescriptions for drugs and substances.
Differences in Regulation between New Mexico and California
New Mexico
For APRNs to have the capacity to prescribe Schedule II- oriented substances (controlled), they are required to undertake a complete educational program on the prescription of Schedule II substances that are regulated. Three-semester-long course work in advanced pathophysiology and pharmacology coupled with training on physical assessment needs the APRNs to get certification in prescriptive authority. Besides, APRNs need to undertake coursework in pharmacotherapeutics, pharmacology, and health assessment ( Advanced practice nurse requirements, n.d.). The training helps them to develop the capacity to handle patient needs and reduce the risks associated with the prescription of controlled substances in the State of New Mexico.
Profoundly, the independent authority for prescription allows the APRNs to carry out prescriptive roles on the controlled and legend or prescription drugs within the state. Further, it enables the APRN to handle medical goods, supplies, and equipment required in the process of prescription. An NP (Nurse-Practitioner) and a NA (Nurse-Anesthesiologist) must clock 400 hours regarding preceptorship for them to be granted prescriptive authority in New Mexico and other states ( Advanced practice nurse requirements, n.d.). Additionally, the requirement is pardonable if the NP and NA have undergone 400 hours of practical experience in a prescriptive environment.
Taking consideration clinical nurses (CN), the educational requirement established for them requires that they undertake advanced coursework that is easily verifiable in the areas of pharmacology, pathophysiology, and assessment ( Advanced practice nurse requirements, n.d.). Again, the CN must provide proof of work experience, which may be substituted for a university-oriented preceptorship under supervision. Agreeably, the set licensing authority mandated to oversee prescriptive authority may accept 45-hours given continuing education related to advanced coursework in the area of pharmacology. In this regard, a CN who lacks verifiable work experience of 400 hours may undergo authorization regarding preceptorship when he or she completes the relevant advanced coursework set for the license ( Advanced practice nurse requirements, n.d.). The specialist CNs who lack the required work experience with an environment of prescriptive capacity is needed for the licensing authority to have undertaken advanced coursework in pharmacology.
Indeed, the prescriptive authority accorded to the APRNs is set for renewal on a biennial basis with evaluations of the requirements based on service time. For APRNs who have not been in clinical practice for more than 24 months, the licensing authority mandates them to undertake 24 hours of advanced continuous education (CE) ( Advanced practice nurse requirements, n.d.). The CE division is set for at least 12 hours in the field of clinical management and another 12 hours in the area of pharmacotherapeutics. Without a doubt, the licensing process or program for the APRNs is critical for the achievement of uniformity given the regulatory requirements established for the prescriptive authority in consideration of non-opioid and opioid-oriented substances. Further, the educational needs in advanced pharmacology, physical assessment coupled with diagnosis, and pharmacotherapeutics enable the APRNs to mitigate against safety and health risks ( Advanced practice nurse requirements, n.d.). Indeed, they are associated with an inappropriate prescription for controlled and non-controlled substances.
California
An NP (Nurse-Practitioner) and a NA (Nurse-Anesthesiologist) must clock about 350 hours regarding preceptorship for them to be granted prescriptive authority in New Mexico and other states. Additionally, the requirement is pardonable if the NP and NA have undergone about 350 hours of practical experience in a prescriptive environment ( Advanced practice nurse requirements, n.d.). For clinical nurses (CN), the educational requirement established for them requires that they undertake advanced coursework that is easily verifiable in pharmacology, pathophysiology, and assessment. The CN must provide proof of work experience, which may be substituted for a university-oriented preceptorship under supervision ( Advanced practice nurse requirements in California, n.d.). Agreeably, the set licensing authority mandated to oversee prescriptive authority may accept 35-hours given continuing education related to advanced coursework in the area of pharmacology.
Indeed, it is required that APRNs must have clocked 45 hours of relevant advanced pharmacology and requisite training in clinical management established for drug therapy. Indeed, a 6-month long program on work experience under the supervision of a physician is required, coupled with advanced coursework in the field of pharmacology. Besides, APRNs need to undertake coursework in pharmacotherapeutics, pharmacology, and health assessment ( Advanced practice nurse requirements in California, n.d.). The training helps them develop the capacity to handle patient needs and reduce the risks associated with prescription controlled substances in the United States.
Agreeably, further coursework in advanced management and diagnosis of patient problems within a clinical specialty environment is a prerequisite. Understandably, the prescriptive authority accorded to the APRNs is set for renewal on a biennial basis with evaluations on the requirements based on the time of service ( Advanced practice nurse requirements in California, n.d.). For the APRNs who have not been in the area of clinical practice for more than two (2) years, the licensing authority mandates them to undertake 20 hours of advanced continuous education.
Actions Required to Prescribe in California
Fundamentally, the licensing process or program for the APRNs in California is critical for the achievement of uniformity given the regulatory requirements established for the prescriptive authority in consideration of non-opioid and opioid-oriented substances. Further, the educational needs in advanced pharmacology, physical assessment coupled with diagnosis, and pharmacotherapeutics enable the APRNs to mitigate against the safety and health risks associated with an inappropriate prescription for controlled and non-controlled substances ( Advanced practice nurse requirements in California, n.d.). Moreover, the physical assessment and set diagnosis help the APRNs understand the medical history of the patients and their state of physical health before offering any prescription.
Essentially, for APRNs in California, a 6-month long program on work experience under the supervision of a physician is required, coupled with advanced coursework in the field of pharmacology. Again, for APRNs to have the capacity to prescribe Schedule II- oriented substances (controlled), they are required to undertake a complete educational program on the prescription of Schedule II substances, which are held ( Advanced practice nurse requirements in California, n.d.). Three-semester-long course work in advanced pathophysiology and pharmacology coupled with training on physical assessment needs the APRNs to get certification on prescriptive authority. Besides, APRNs need to undertake coursework in pharmacotherapeutics, pharmacology, and health assessment.
Profoundly, in California, the prescriptive authority accorded to the APRNs is set for renewal on a biennial basis with evaluations on the requirements based on the time of service. For the APRNs who have not been in clinical practice for more than 24 months, the licensing authority mandates them to undertake 24 hours of advanced continuous education (CE). The CE division is set for at least 12 hours in the field of clinical management and another 12 hours in the area of pharmacotherapeutics ( Advanced practice nurse requirements in California, n.d.). The training helps them to develop the capacity to handle patient needs and reduce the risks associated with the prescription of controlled substances in the State of California.
In the State of California, a Clinical Nurse (CN) who lacks verifiable work experience of about 350 hours may undergo authorization regarding preceptorship when he or she completes relevant advanced coursework set for the license. The specialist CNs who lack the required work experience with an environment of prescriptive capacity is needed for the licensing authority to have undertaken advanced coursework in pharmacology. Considering the training and educational requirements, advanced coursework related to the areas of pharmacology, pathophysiology, and assessment is critical. Again, the CN must provide proof of work experience, which may be substituted for a university-oriented preceptorship under supervision ( Advanced practice nurse requirements in California, n.d.). Agreeably, the set licensing authority mandated to oversee prescriptive authority may accept 35-hours given continuing education related to advanced coursework in the area of pharmacology and pharmacotherapeutics.
In California, the independent authority for prescription allows the APRNs to carry out prescriptive roles on the controlled and legend or prescription drugs within the state. Further, it enables the APRN to handle medical goods, supplies, and equipment required in the process of prescription ( Advanced practice nurse requirements in California, n.d.). An NP (Nurse-Practitioner) and a NA (Nurse-Anesthesiologist) must clock about 350 hours concerning preceptorship for them to be granted prescriptive authority in New Mexico and other states. Additionally, the requirement is pardonable if the NP and NA have undergone about 350 hours of practical experience in a prescriptive work environment.
Controlled Substances Regulations in New Mexico and DEA Registration-Process
Substance-Regulations
For the state of New Mexico, APRNs are mandated to have clocked 45 hours of relevant advanced pharmacology and requisite training in clinical management established for drug therapy. They should also have a 6-month long program on work experience under the supervision of a physician is required, coupled with advanced coursework in the field of pharmacology. Again, for APRNs to have the capacity to prescribe Schedule II- oriented substances (controlled), they are required to undertake a complete educational program on the prescription of Schedule II substances, which are held.
A consideration involving a three semester-long course work in advanced pathophysiology and pharmacology coupled with training on physical assessment is needed for the APRNs to get certification on prescriptive authority. Besides, APRNS needs to undertake coursework in pharmacotherapeutics, pharmacology, and health assessment ( Advanced practice nurse requirements in California, n.d.). The training helps them develop the capacity to handle patient needs and reduce the risks associated with the prescription of controlled substances in the United States.
Further coursework in advanced management and diagnosis of patient problems within a clinical specialty environment is a prerequisite. The prescriptive authority accorded to the APRNs is set for renewal on a biennial basis with evaluations on the requirements based on the time of service ( Advanced practice nurse requirements in California, n.d.). For APRNs who have not been in clinical practice for more than 24 months, the licensing authority mandates that they undertake 24 hours of advanced continuous education (CE) ( Advanced practice nurse requirements in California, n.d.). The CE division is set for at least 12 hours in the field of clinical management and another 12 hours for the area of pharmacotherapeutics.
DEA Registration
The registration procedure for my DEA (Drug-Enforcement-Agency) identity number shall involve the following steps. First, I must start by obtaining an order form (official) by making an online application on the Department-of-Justice website in the United States (Nursing-Licensure, 2020). Alternatively, I may opt to call the Registry Department at the DEA Headquarters using a tool-free line. Further, I may consider consulting a DEA Field Office concerned with registration and requesting a hard copy of the registration document (form). Within a matter of ten (10) business days, my mailing of the paper will have been completed ( Advanced practice nurse requirements in California, n.d.). After that, I am required to submit a formal requisition form that is dully filled, Form 222a (DEA), for mailing to the registrant within 30 days and wait for my DEA number.
A Summary of the Main Concepts for CDC Module 1 and Module 4
Module 1
Undoubtedly, the 1st module from CDC (Centers-for-Disease-Control-and-Prevention) focuses on the strategies and approaches to addressing the opioid epidemic in the United States. Indeed, the module provides insightful guidelines from the CDC on the prescription guidelines for the effective and safe use of prescription opioids ( Interactive training series, 2020). Further, the module outlines recommendations that apply to opioids in the management and treatment of acute pain. The module asserts that there are severe impacts that emerge from the use of opioid doses, and they have contributed negatively to the adversity of the epidemic. One of the module speakers outlines that the opioid epidemic has resulted in about 180 000 deaths in the United States ( Interactive training series, 2020). The module recommends that the APRNs and other primary caregivers take professional caution as they prescribe opioid-oriented medication.
Furthermore, the module affirms that CDC is keen on protecting the American peoples safety and health by mitigating the health risks that may arise from inappropriate doses of opioid drugs. Indeed, addiction from the use of a prescription opioid is a critical concern within the American healthcare system ( Interactive training series, 2020). A majority of the primary caregivers defend their position on the recommendation of prescription opioids for the management (treatment) of acute pain in patients. However, experts from the CDC argue that there are more effective methods and approaches that can be applied in managing pain among patients without causing severe harm to the patients health ( Interactive training series, 2020). For instance, the use of therapy is a promising approach to the alleviation of pain in patients.
CDC highlights that the challenge of inadequate training for the healthcare professionals serving within the primary care setting presents a challenging position in managing the administration of prescription opioids. In this regard, primary caregivers must know the following aspects: when to initiate a dosage, the appropriate selection of the dose and the specific time of prescription, and assessment of the potential harm presented by the opioid.
Module 4
Certainly, module 4 premises on reducing the risks associated with the use of opioids. Besides, the module is keen on communicating the need to apply the CDCs comprehensive guidelines related to prescription opioids (( Interactive training series, 2020). One of the essential highlights of the module has to be the discussion of the fundamental strategies applied to the mitigation of risks associated with or linked to the use of opioids. Further, monitoring programs for the patients who have taken subscriptions for an opioid feature in the module ( Interactive training series, 2020). The CDC guidelines direct medical care professionals, especially the primary caregivers, to evaluate the patients medical history before taking action on prescription opioids.
Moreover, the CDC guidelines on prescription opioids recommend that undertaking a physical examination of a patient before prescribing an opioid helps mitigate health risks linked to opioid use. In the module, healthcare professionals are advised to fathom scenarios or situations that may be potentially risky to the health outcomes of a patient who may be on a dose of opioid therapy ( Interactive training series, 2020). Risk analysis (assessment) has been discussed in the module whereby caregivers have been guided to use clinical tests and tools to mitigate and reduce health risks arising from opioid use. PDMP (Prescription-Drug-Monitoring-Program) features an effective strategy in the process of decision-making within the clinical setting for the administration of prescription opioids ( Interactive training series, 2020). Further, UDT (Urine-Drug-Testing) features as an additional test for patients before they are subjected to opioid therapy; hence, the objective of risk mitigation is eliminated.
Without a doubt, the enhancement of strategies for opioids prescription shall ensure that patients will be in a position to access reliable, more effective, and safer treatment for acute or chronic pain. Moreover, the strategy shall reduce opioid overdose, abuse, and misuse ( Interactive training series, 2020). Precisely, the various tests on the patients, UDTs, and PDMPs have a goal of promoting patient safety by providing updated and timely data on potentially dangerous combinations and identifying the number of prescribers linked to the patient.
Plan for Implementing Safe Prescribing Practices as an APRN
Premise on States Guidelines
As an ARPN, I will have to clock 45 hours of relevant advanced pharmacology and requisite training in clinical management established for drug therapy. Besides, I will take a 6-month long program on work experience under the supervision of a physician coupled with advanced coursework in pharmacology. Again, as an APRN, for me to have the capacity to prescribe Schedule II- oriented substances (controlled), I will be required to undertake a complete educational program on the prescription of Schedule II substances which are held ( Advanced practice nurse requirements, n.d.). Indeed, I will consider taking three (3) semester-long course work in advanced pathophysiology and pharmacology, coupled with training on physical assessment to facilitate my certification on prescriptive authority by the state of New Mexico. Besides, it is essential for me as an APRN to undertake comprehensive coursework in pharmacotherapeutics, pharmacology, and health assessment ( Advanced practice nurse requirements, n.d.). Indeed, the training will help me to develop the capacity to handle patient needs and reduce the risks associated with the prescription of controlled substances in the state of New Mexico.
Premise on CDC Opioid-Guidelines
According to the objectives set in Module 1, I shall endeavor to follow the strategies and approaches to be applied in addressing the opioid epidemic (prevalence) in the United States. Further, borrowing from the 1st module, I shall gather insightful guidelines from the CDC on the prescription procedures for the effective and safe use of prescription opioids ( Interactive training series, 2020). Besides, given pain treatment, I plan to obey the 1st modules recommendations that apply to opioids in managing and treating acute pain. I shall be careful to reduce the severe impacts that emerge from the use of opioid doses and know that they have contributed negatively to the adversity of the epidemic. Understanding that the opioid prevalence or epidemic has resulted in about 180 000 deaths in the United States ( Interactive training series, 2020), I shall keenly adhere to the 1st modules recommendation on the need for APRNs and other healthcare professionals to take professional judgment while prescribing opioid-oriented medication.
Without a doubt, I will be prudent in protecting the American peoples safety and health by mitigating the health risks that may arise from inappropriate doses of opioid drugs. I am fully cognizant of the premise that addiction from the use of a prescription opioid is a critical concern within the American healthcare system ( Interactive training series, 2020). I will adhere to the CDC experts advice on the consideration of more effective methods and approaches that can be applied in managing pain among patients without causing severe harm to their health of the patients. In my plan, I shall focus on using therapy as a promising approach to alleviating pain in patients ( Interactive training series, 2020). As a forward-looking APRN, I shall acquire knowledge of the following aspects: when to initiate a dosage, the appropriate selection of the dose and the specific time of prescription, and assessment of the potential harm presented by the opioid.
Considering the recommendation established in the 4th module by CDC, I shall be committed to reducing the risks linked (associated) with the use of opioids. Besides, I will be keen on communicating the need to apply the CDCs comprehensive guidelines relating to the prescription of opioids to my peers serving as APRNs in various facilities across New Mexico and the United States in general ( Interactive training series, 2020). From the understanding of the 4th module guidelines, I shall familiarize myself with the fundamental strategies applied toward the mitigation of risks associated with or linked to the use of opioids. Again, I will endeavor to undertake monitoring programs for the patients who have taken subscriptions for opioids ( Interactive training series, 2020). As an APRN or medical-care professional, I will evaluate the patients medical history before taking action on prescription opioids.
Based on the CDCs 4th module, my plan will involve undertaking a physical examination of a patient before prescribing an opioid; thus, helping to mitigate health risks linked to opioid use. From the lessons in the module, I shall analyze scenarios or situations that may be potentially risky to the health outcomes of a patient who may be on a dose of opioid therapy ( Interactive training series, 2020). As an APRN, a risk assessment will be a primary consideration for my practice since I will undertake clinical tests and use tools to mitigate and reduce health risks arising from opioid use. I will carry out PDMPs (Prescription-Drug-Monitoring-Program) as an essential strategy in decision-making within the clinical setting for the administration of prescription opioids ( Interactive training series, 2020). Again, my plan will incorporate UDT (Urine-Drug-Testing) as an additional test for patients before they are subjected to opioid therapy; hence, eliminating any medical or health risks.
The fact that an increasingly large number of patients undergoing opioid treatment are developing or have already developed a dependency on the drugs that are administered to them is undeniable (Kaplan, 2016). Defined as the opioid crisis, it is becoming a reason for a major concern in the United States (Kaplan, 2016). According to the recent statistical data provided by the American Society of Addiction Medicine (2016), at least 10% of Americans over 12 had an opioid addiction in 2015. Exploring the effects of using patient education combined with a change in the process of administering drugs will require the application of a framework comprised of cognitive therapy based on the constructivist and humanist theories of learning. The specified strategy will allow both changing the attitude toward drug intake among patients and the idea of managing the target population’s needs among nurses.
Cognitive Approach
The significance of using the approach rooted in cognitive therapy is justified by the fact that the process of educating both nurses and patients must be the primary focus of the program. Although changing the dose prescribed to patients is also an essential step in managing the issue, it will be impossible without a conscious attempt at changing the situation made by a patient, as well as the recognition of the necessity to build a dialogue with the patient acknowledged by a nurse (Costello, Thompson, Aurelien, & Luc, 2016). Herein the significance of the cognitive therapy framework lies. By definition, it implies that an individual engages in the active observation of accepted practices and behaviors, thus, developing the required attitudes and skills (Manworren & Gilson, 2015). The strategy in question is especially efficient when implementing a learning program for nurses (Freedland, Carney, Rich, Steinmeyer, & Rubin, 2015).
Humanist Approach
The humanist theory, in turn, will provide patients with the agency that they need to handle the development of drug dependence successfully. Indeed, according to the primary tenets of the specified framework, it is essential to encourage the independence of the target population to promote the necessary changes and increase the speed and efficacy of knowledge acquisition by patients (Souza, Mesquita, Antoniolli, Lyra, & Silva, 2015). The specified framework is especially important in the management of the opioid crisis seeing that it will allow patients to recognize the problem and fight their addiction willingly. Indeed, according to the primary tenets of the humanist framework, the process of constructing meaning is the essential step toward developing an understanding of a specific issue and acquiring the skills and habits that will allow patients to control the process of recovery, thus, contributing to it significantly. By applying the identified approach toward exploring the effects of patient education, one will be able to determine the possibility of introducing the principle of self-actualization into the process of patient education. Consequently, the patients’ agency in handling the issue of opioid dependence can be measured successfully. As a result, the foundation for building the management framework based on active learning and the enhancement of the communication process between a nurse and a patient becomes a possibility.
Conclusion
In addressing the opioid crisis, the introduction of patients to the concept of independence and enhancing a patient-centered approach as a nursing framework is crucial. Thus, the premise for an in-depth analysis will be created. The application of the identified theoretical frameworks will serve as the means of gaining a deeper insight into the way in which the suggested management techniques will work.
Costello, M., Thompson, S., Aurelien, J., & Luc, T. (2016). Patient opioid education: Research shows nurses’ knowledge of opioids makes a difference. MEDSURG Nursing, 25(5), 307-312.
Freedland, K. E., Carney, R. M., Rich, M. W., Steinmeyer, B. C., & Rubin, E. H. (2015). Cognitive behavior therapy for depression and self-care in heart failure patients: a randomized clinical trial. JAMA Internal Medicine, 175(11), 1773-1782. Web.
Kaplan, L. (2016). Advocate for NPs to be part of the solution to the opioid epidemic. The Nurse Practitioner, 41(8), 20.
Manworren, R. C. B., & Gilson, A. M. (2015). Nurses’ role in preventing prescription opioid diversion. The American Journal of Nursing, 115(8), 34-40.
Souza, W. M. D., Mesquita, A. R., Antoniolli, A. R., Lyra Junior, D. P. D., & Silva, W. B. D. (2015). Teaching in pharmaceutical care: A systematic review. African Journal of Pharmacy and Pharmacology, 9(10), 333-346. Web.
Problem Statement, Suggested Solution, and Research Purpose
The problem of the opioid crisis has been brewing for quite long in the environment of American healthcare. While opioids are currently the only means of relieving the pain from which cancer patients suffer, the current policies concerning the prescription of the medications such as Fentanyl lead to a rapid development of addiction (Volkow, Frieden, Hyde, & Cha, 2014). Therefore, the lack of the appropriate management strategies for preventing addiction among cancer patients must be viewed as an evident problem.
As stressed above, shaping the process of drug medications intake, including the dosage, the frequency, and the amount of the medication provided to the patient, one will be able to handle the issue of opioid crisis in cancer patients. A change in the schedule of the drug intake should also be viewed as an efficient strategy for addressing the instances of chemical dependency development among patients. The identified approaches must be combined with the active promotion of patient education as the means of reducing the deleterious side effects of the medicine. Specifically, patients must be aware of the threat of developing dependency, as well as the tools that must be used to prevent the problem from reaching a drastic scale.
The purpose of the research is, therefore, to compare the traditional tools for managing the opioid crisis in the U.S. healthcare setting and the interventions suggested above. Thus, opportunities for improving the quality of care to a considerable extent will be created. As a result, a rapid improvement in patient outcomes is expected.
Research Proposal Draft: Addressing the Issue of Opioid Crisis in Patients
Introduction
Creating the setting in which patients are provided with the necessary care for alleviating pain and improving the overall quality of life levels is a crucial task faced by the contemporary healthcare practitioners. The specified task requires not only incorporating time-tested techniques that have proven to have a positive effect on the target demographics but also exploring the available opportunities for alleviating pain and preventing possible side effects. Particularly, it is crucial to introduce scheduling techniques, as well as the tools for patient education as the means of managing the opioid crisis that has been spreading across the U.S. healthcare facilities over the past few decades (Kolodny et al., 2015).
Background and Significance of the Problem
The issue has been building in the environment of the American healthcare for quite a while. At present, connections are made between a drop in life expectancy rates among American patients and the provision of standard opioid treatment strategies; particularly, it is assumed that the promotion of the framework leads to at least two-year reduction in life expectancy levels (“Opioid crisis linked to two-year drop in US life expectancy,” 2017). Seeing that the development of chemical dependency leads to significant health issues, as well as a threat of an overdose, the significance of the problem must be deemed as quite large. Without an appropriate intervention, the death toll among the target population is bound to rise, whereas the quality of their lives will drop systematically.
Statement of the Problem and Purpose of the Study
As stressed above, the lack of a coherent prevention and management tool for addressing the instances of developing drug dependency among the patients that are prescribed with medications such as Fentanyl, i.e., the drugs that fall under the category of synthetic pain relievers, should be viewed as the primary problem. The purpose of the study is to define the efficacy of using patient education combined with a change in the process of scheduling and dosing the said medicine to patients that require opioid treatment. Thus, opportunities for improving patient outcomes and the quality of their life can be created (Bohnert et al., 2016).
Research Questions, Hypothesis, and Variables with Operational Definitions
Research Question
Does a change in the process of administering the medications that cause dependency, such as Fentanyl, e.g., a different schedule and a reduction of the amount of the medicine, combined with the active promotion of patient education, allow reducing the death toll caused by overdosing and the side effects caused by the specified drugs among the target population?
Hypothesis: Research and Null
The research hypothesis is that the combination of patient education and a change in the dose of and time for administering the required opioid-based medication to patients will help reduce the side effects, including the drop in life expectancy levels among the identified demographics and the improvement in the quality of their lives. The null hypothesis suggests that there be no tangible difference between the outcomes of either of the techniques.
Identifying and Defining Study Variables
The change in the degree and speed of chemical dependency development is the primary dependent variable of the study. The traditional techniques of reducing pain, i.e., the adoption of opioids, as well as the suggested alternative, including a change in the amount of medicine and the promotion of patient education and agency, are the essential independent variables. Comparing the effects of the two on the patients’ well-being and pain levels will allow defining the ultimate strategy for addressing the issue of opioid crisis.
Operationalized Variables
The process of measuring the variables mentioned above is quite complicated since the perception of pain varies depending on the unique characteristics of a patient. Therefore, a combination of verbal and numerical rating scales will have to be used to determine the pain levels accurately (Ruskin et al., 2014). Thus, the two strategies suggested above will be compared successfully.
References
Bohnert, A. S., Bonar, E. E., Cunningham, R., Greenwald, M. K., Thomas, L., Chermack, S.,… Walton, M. (2016). A pilot randomized clinical trial of an intervention to reduce overdose risk behaviors among emergency department patients at risk for prescription opioid overdose. Drug and Alcohol Dependence, 163, 40-47.
Kolodny, A., Courtwright, D. T., Hwang, C. S., Kreiner, P., Eadie, J. L., Clark, T. W., & Alexander, G. C. (2015). The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annual Review of Public Health, 36, 559-574.
Ruskin, D., Lalloo, C., Amaria, K., Stinson, J. N., Kewley, E., Campbell, F.,… McGrath, P. A. (2014). Assessing pain intensity in children with chronic pain: Convergent and discriminant validity of the 0 to 10 numerical rating scale in clinical practice. Pain Research and Management, 19(3), 141-148.
Volkow, N. D., Frieden, T. R., Hyde, P. S., & Cha, S. S. (2014). Medication-assisted therapies – Tackling the opioid-overdose epidemic. New England Journal of Medicine, 370(22), 2063-2066.
The opioid crisis has been taking an increasingly large scale over the past few years for a range of reasons (Naegle et al., 2017). The first and most obvious, the fact that healthcare services must cater to the needs of a very diverse population and, therefore, may fail to deliver the essential information or identify patients’ needs must be mentioned (Simpatico, 2015). Thus, the promotion of education for nurses and patients must be deemed as the primary step to be taken to handle the opioid crisis.
When considering the opportunities for improving the current situation regarding the opioid crisis in the United States, one could also suggest the option of patient education. Raising awareness among vulnerable populations affected by the subject matter will allow not only dealing with the problem more efficiently but also preventing its further spread among the target population (Naegle et al., 2017). Therefore, it is crucial to make sure that nurses have the skills and knowledge required to encourage the vulnerable population to learn more about the problem and develop resilience toward drug abuse. For instance, the recent research on the subject matter shows that patients are inclined to develop a sensible attitude toward the use of opioids as long as nurses demonstrate a clear understanding of safe practices as far as prescription opioids are concerned (Costello, Thompson, Aurelien, & Luc, 2016). In other words, prior to introducing an educational intervention to the target audience, the enhancement of nurses’ knowledge of the issue of the opioid crisis and the means of managing it must take place.
The specified change in the process of raising awareness among patients is justified by the fact that, at present, nurses tend to overlook some of the crucial aspects of patient education, while providing important guidelines regarding other aspects of proper drug intake (Simpatico, 2015). Particularly, the fact that nurses currently fail to “routinely teach patients how to secure and dispose of prescribed controlled substances” (Manworren & Gilson, 2015, p. 36) needs to be mentioned as a major reason for concern. Therefore, designing a set of strategies aimed at increasing the level of skill and proficiency among nurses is critical to the further management of the opioid crisis. Apart from educating patients, nurses must also consider giving the relevant information to their family members. As a result, the target population will be provided with the support that patients will need to abstain from opioids abuse and the efficient management of their disease. In addition, the enhancement of the patient education process is bound to lead to a significant reduction of the bacterial drug resistance rates among patients (Manworren & Gilson, 2015).
The issue of preventing opioid addiction should be viewed as equally significant, if not more important, compared to the management thereof, as the study conducted by Kaplan (2016) shows. Kaplan (2016) also stresses the gravity of poor cooperation in the nursing setting. Particularly, the author emphasizes the fact that poor collaborative efforts are bound to lead to miscommunication and the further inability to meet the needs of the target population. By creating the framework for enhancing the process of knowledge acquisition among both patients and nurses, one will be able to provide the target population with high-quality support and make sure that their needs are met accordingly. The specified outcome is especially important for the people that are addicted to opioids since handling their addiction will require impressive willpower and consistent support from nurses and family members.
References
Costello, M., Thompson, S., Aurelien, J., & Luc, T. (2016). Patient opioid education: Research shows nurses’ knowledge of opioids makes a difference. MEDSURG Nursing, 25(5), 307-312.
Kaplan, L. (2016). Advocate for NPs to be part of the solution to the opioid epidemic. The Nurse Practitioner, 41(8), 20. Web.
Manworren, R. C., & Gilson, A. M. (2015). CE: Nurses’ role in preventing prescription opioid diversion. AJN The American Journal of Nursing, 115(8), 34-40. Web.
Naegle, M., Mitchell, A. M., Flinter, M., Dunphy, L., Vanhook, P., & Delaney, K. R. (2017). Opioid misuse epidemic: Addressing opioid prescribing and organization initiatives for holistic, safe and compassionate care. Nursing Outlook, 65(4), 477-479. Web.
Simpatico, T. A. (2015). Vermont responds to its opioid crisis. Preventive Medicine, 80(1), 10-11. Web.
The problem of substance use is a serious problem for modern nursing to address. At present, $78.5 billion people suffer from opioid use (National Institute on Drug Abuse, n.d.). Due to the devastating effects of substance abuse, it is critical to prevent the aggravation of the issue. For this purpose, the use of the Screening, Brief Intervention, and Referral to Treatment (SBIRT) technique has to be considered (SBIRT Education, 2015). The specified tool allows locating a source of concern early and manage it in a timely fashion, which makes it a crucial component of diagnosing and treating substance use.
SBIRT description
Screening
In the described case, the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) should be used to diagnose the problem. The specified screening tool will help patients to shape their behavior regarding substance use (World Health Organization, n.d.). Furthermore, the results of the test will inform the following intervention strategy.
Brief Intervention (BI)
The BI stage will include a change in patients’ perception of the issue. A BI aimed at encouraging a patient to change his current behavior will be needed (DiClemente, Crouch, Norwood, Delahanty, & Welsh, 2015). Particularly, the BI should focus on helping patients to restore their connection to their family members and gain their support to motivate them to recover.
Referral to Treatment (RTT)
Patients will be provided with brief treatment, which will incorporate other factors that motivate the patient to manage his substance use disorder. A nurse will discuss socioeconomic issues with them, exploring the solutions to some of their current problems with finances. The support of Substance Abuse and Mental Health Services Administration (SAMSA) as an important resource will also be discussed (Substance Abuse and Mental Health Services Administration, 2018). Finally, the lack of social support will be addressed by helping patients to regain the trust of his friends.
Video Description
The problem of opioid use is a common issue in modern American society. The video by Wall Street Journal (2017) shows that the specified health concern has grown out of proportions and, therefore needs an urgent intervention. The video introduces a pre-charge program, which is expected to assist people with opioid addictions in managing them.
Problem Description
The problem of opioid addiction is rather common in the local community. A vast range of people who come from a poor socioeconomic background and do not have proper healthcare options are affected by this problem. Obtaining patients’ personal information and medical history for the purpose of improving the quality of care for substance use is critical (see Appendix A). Furthermore, financial struggles and family relationships need to be addressed to manage this problem. The use of drugs such as Oxycodone to address a severe chronic pain typically causes the development of an opioid addiction in patients (Stringer & Baker, 2015). Being unable to manage the problem himself, patients need to ask for assistance from a local healthcare facility, yet the social stigma may affect their decisions. Moreover, patients are under a constant threat of relapse and, thus experience significant stress.
Community Resources
In managing substance use disorders, one needs to ensure community support. Unfortunately, a plethora of myths about substance use currently circulate the global community, hampering the treatment of the problem in a number of patients (Stringer & Baker, 2015). Therefore, information resources have to be used to build awareness and reduce the harmful impact of myths linked to substance use. For instance, one may use the support of the SBIRT Education (2015) and the National Institute on Drug Abuse (n.d.). The SBIRT Education (2015) provides information about the application of the SBIRT strategy to enhance the recovery process. In turn, the National Institute on Drug Abuse (n.d.) offers general information required for patient education and health promotion.
Conclusions
Because of the opportunity to locate and manage substance use issues, the SBIRT tool has to be introduced into the contemporary nursing setting. In the case under analysis, patients will require a detailed SBIRT assessment to produce an appropriate treatment strategy and prevent comorbid diseases from developing. Therefore, the application of SBIRT offers a chance to allocate available resources and utilize them properly to meet a patient’s needs. Furthermore, the framework should be integrated into the community as a precautionary measure for handling the instances of substance use. As a result, the problem of addictive disorders will be addressed in the community.
References
DiClemente, C. C., Crouch, T. B., Norwood, A. E. Q., Delahanty, J., & Welsh, C. (2015). Evaluating training of screening, brief intervention, and referral to treatment (SBIRT) for substance use: Reliability of the MD3 SBIRT Coding Scale. Psychology of Addictive Behaviors, 29(1), 218-224. doi:10.1037/adb0000022
Stringer, K. L., & Baker, E. H. (2018). Stigma as a barrier to substance abuse treatment among those with unmet need: An analysis of parenthood and marital status. Journal of Family Issues, 39(1), 3-27. doi:10.1177%2F0192513X15581659
The abuse of opioids in the United States is a problem that has been observed in recent decades. In 2017, it was characterized by President Donald J. Trump as the opioid crisis affecting the public health. The use of opioids in the context of pain management adopted in healthcare facilities depends on the effectiveness of these painkillers to address chronic and acute pain and avoid its recurrence (Stoicea et al., 2019).
However, the problem is that the prescription and use of opioids can potentially lead to drug misuse and addiction (Nicol, Colquhoun, & Brummett, 2019). Although opioids have been effectively used in the US healthcare for many years, the problems associated with over-prescription of these drugs and their abuse have led to the opioid crisis, and the purpose of this paper is to discuss its causes, consequences, and possible solutions.
The opioid crisis is the situation currently observed in the US healthcare and viewed as a public health issue related to the increased rates of opioid dependence disorders and overdose deaths reported in the country in recent years. According to Nicol et al. (2019), “opioid drug overdoses killed about 72,000 Americans in 2017,” and “1 in every 25 adults … regularly uses prescription opioids” (p. 16). The causes of the opioid crisis discussed by experts include the activities of the manufacturers of medications, like Purdue Pharma (Childers, 2019).
Additionally, the problem is in the over-prescription of these drugs by physicians, which is supported by the Big-Pharma industry. One more cause is the lack of effective control over the distribution of these risky products (Argento, Tupper, & Socias, 2019). Still, governmental agencies do not provide a direct answer to the question about the causes of the opioid crisis.
If the opioid crisis in the US is not resolved, the number of deaths due to the overdose of opioids will increase in association with the availability of medications. The major negative consequence of the opioid crisis is the increasing drug addiction among Americans because of the popularity of opioids to be used in both healthcare and home settings (Argento et al., 2019; Childers, 2019). State and local governments require many resources, including financial ones, to address the problem.
The recognition of the crisis in 2017 has led to authorities’ and researchers’ activities oriented toward finding solutions to the problem. One of the first steps was filing lawsuits against the manufacturers of opioid drugs to receive resources to support communities and contribute to public health promotion (Childers, 2019).
Another solution is related to financing state and community rehabilitation programs to support opioid addicts and educate individuals and healthcare providers regarding the risks of using these medications (Argento et al., 2019; Stoicea et al., 2019). Additional research is required to understand how available and alternative pharmacotherapy can be utilized instead of opioids and address the drug use disorder.
Although the use of opioids is viewed as an effective means of analgesia, the abuse of these medications, along with other factors, has led to the crisis in the US. The determination of the causes of the problem, as well as the analysis of the role of drug manufacturers in the process, is important to emphasize effective solutions. Much attention should be paid to controlling the use of opioids in healthcare settings, developing alternative approaches to pain management, preventing overdose episodes, and treating current opioid drug addicts.
References
Argento, E., Tupper, K. W., & Socias, M. E. (2019). The tripping point: The potential role of psychedelic-assisted therapy in the response to the opioid crisis. International Journal of Drug Policy, 66, 80-81.
Childers, T. (2019). The opioid crisis: The states’ and local governments’ response to bigpharma’s deception and why the supremacy clause may provide a cloak for opioid manufacturers to hide behind. Barry Law Review, 24(1), 59-77.
Nicol, A. L., Colquhoun, D. A., & Brummett, C. M. (2019). The more you know: Identifying factors associated with inpatient mortality related to opioid overdose can drive progress in the opioid health crisis. Anesthesia and Analgesia, 128(1), 16-18.
Stoicea, N., Costa, A., Periel, L., Uribe, A., Weaver, T., & Bergese, S. D. (2019). Current perspectives on the opioid crisis in the US healthcare system: A comprehensive literature review. Medicine, 98(20), 1-8.