Research question: To what extent has the Canadian Government mounted enlightenment campaigns against opioid addictions and abuse in Canadian high schools and colleges have the effects of these addictions been entrenched in their education curriculum?
Belzak, L., & Halverson, J. (2018). Evidence synthesis – the opioid crisis in Canada: A national perspective. Health Promotion and Chronic Disease Prevention in Canada, 38(6), 224–233. Web.
In this article, Belzak and Halverson (2018) conclude the Canadian opioid crisis based on incidents, fatal cases, and potential risks associated with the issue. The authors analyzed all public-facing opioid-related observations and epidemiological reports introduced by healthcare and medical investigation offices. Additionally, they compared mortality and morbidity rates of national and regional trends. The investigation aimed to provide evidence regarding fatal cases and harmful incidents in regions. Their research identified the means of the national opioid crisis and offered possible trends associated with the issue. The article is helpful for my research topic because it highlights opioid addiction and abuse as a national problem. Moreover, it provides statistical evidence about the gender, age, and social status of addicted people. The article will not form the basis of my research; nevertheless, it indicates critical data to highlight the issue.
Probst, C., Elton-Marshall, T., Imtiaz, S., Patte, K. A., Rehm, J., Sornpaisarn, B., & Leatherdale, S. T. (2020). A supportive school environment may reduce the risk of non-medical prescription opioid use due to impaired mental health among students. European Child & Adolescent Psychiatry, 30(2), 293–301. Web.
In this article, Probst et al. (2020) stated the importance of a supportive school environment in the reduction of non-medical opioid use and connected it with the mental health issues of students. The authors aimed to identify the link between behavioral mental health impairment and opioid addiction among students. Their methods included the analytical strategy of hierarchal multilevel regression and examination of self-reported, cross-sectional data. The finding discovered the importance of mental health support in schools regulating substances use. This article is practical for my research as it defines the link between mental health and opioid addiction among adolescents. Moreover, it considers additional factors that could help to prevent and eliminate this. This article will create the ground to understand the enlightenment campaigns and their effectiveness from different perspectives.
Vosburg, S. K., Eaton, T. A., Sokolowska, M., Osgood, E. D., Ashworth, J. B., Trudeau, J. J., Muffett-Lipinski, M., & Katz, N. P. (2016). Prescription opioid abuse, prescription opioid addiction, and heroin abuse among adolescents in a recovery high school: A pilot study. Journal of Child & Adolescent Substance Abuse, 25(2), 105–112. Web.
In this article, Vosburg et al. (2016) point out the relationship between prescription opioid (PXO) abuse and RXO addiction in adolescents by formulating a study. Their research focuses on the characteristics and development of RXO drug abuse, RXO drug addiction, and heroin abuse among adolescents at the recovery stage from opioid addiction. Their pilot study investigated new areas for research such as drug combinations, recovery methods, and pain management among adolescents. It indicated that the use of ADFs limits the transformation of RXO addiction into heroin addiction. This article will help identify additional measures in preventing opioid abuse in Canadian schools and colleges. Moreover, it will introduce adverse outcomes that allow setting prevention measures. This article will provide supplementary information for my study in identifying prevention measures.
References
Belzak, L., & Halverson, J. (2018). Evidence synthesis – the opioid crisis in Canada: A national perspective. Health Promotion and Chronic Disease Prevention in Canada, 38(6), 224–233. Web.
Probst, C., Elton-Marshall, T., Imtiaz, S., Patte, K. A., Rehm, J., Sornpaisarn, B., & Leatherdale, S. T. (2020). A supportive school environment may reduce the risk of non-medical prescription opioid use due to impaired mental health among students. European Child & Adolescent Psychiatry, 30(2), 293–301. Web.
Vosburg, S. K., Eaton, T. A., Sokolowska, M., Osgood, E. D., Ashworth, J. B., Trudeau, J. J., Muffett-Lipinski, M., & Katz, N. P. (2016). Prescription opioid abuse, prescription opioid addiction, and heroin abuse among adolescents in a recovery high school: A pilot study. Journal of Child & Adolescent Substance Abuse, 25(2), 105–112. Web.
There is an adverse effect of the opioid crisis on the United States. These substances typically result in an addiction, and a more significant aspect implies that they do not address the problem of the source of pain. Instead of it, opioids develop a feeling of euphoria that masks suffering. That is why it is evident that there is no need to legalize heroin, meaning that alternative pain relievers should be created.
Since heroin and other opioids adversely impact the entire nation, a reasonable step is to fund alternative treatments for pain. For example, some researchers consider using marijuana as a pain reliever, but this substance also has some health risks, meaning that this decision should be made with caution (Saloner et al., 2018). However, if medical scientists manage to find an alternative pain management medicine, numerous benefits will arise. In particular, this decision will lead to higher patient safety because opioid overuse is a leading cause of people’s death (Saloner et al., 2018). For example, more than 60,000 people died from a drug overdose in 2016 (Saloner et al., 2018). Furthermore, a significant advantage will refer to expenditure savings because using an alternative pain reliever will not create people who will require additional services. That is why there is no doubt that it is necessary to invest in alternative pain management medicines.
In conclusion, it has been identified that the opioid crisis is a significant challenge for the United States. This problem results in thousands of injured and dead, denoting that alternative pain relievers should be found. Marijuana is a suitable option, but the possible harmful effects of this substance represent why the healthcare industry has not started using it. In any case, researchers should look for alternative pain relievers to protect patients and reduce healthcare expenditures.
Reference
Saloner, B., McGinty, E. E., Beletsky, L., Bluthenthal, R., Beyrer, C., Botticelli, M., & Sherman, S. G. (2018). A public health strategy for the opioid crisis.Public Health Reports, 133(1_suppl), 24S-34S. Web.
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 board’s 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 Association’s 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 people’s 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 CDC’s 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 State’s 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 module’s 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 module’s 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 people’s 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 CDC’s 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 CDC’s 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.
Many prescription drugs are misused, including growth hormones and anabolic steroids. However, opioids are among the most commonly misused drugs. This has become a serious problem in Australia as the misuse of opioid medications has increased over the years. Opioid drugs are among the most powerful analgesics but also among the most addictive. Medically prescribed opioids are generally safe when used as prescribed, but they can become harmful if misused. Examples of misuse include taking more than the prescribed dose or mixing opioids with other medications or with alcohol. This misuse can lead to several adverse health consequences that are serious and preventable. These can include but are not limited to severe respiratory depression, seizures, heart failure, and even death. Additionally, this population may be at risk for other risky behaviors that can contribute to further adverse outcomes. Apart from those deliberately seeking hedonic drug effects, vulnerable individuals may use substances including psychoactive prescription drugs to make themselves feel better. This new, hidden population may differ from the usual drug user stereotypes and be more highly functioning, have higher socioeconomic status, better education, and more social support. The aim of this paper is to identify factors that contributed to opioid misuse in Australia.
Review of the Literature
This study is based on a review of relevant empirical research from academic, government, and non-government sources. Academic sources included JAMA Psychiatry, PubMed, and Proquest. Government and non-government sources included the Australian Institute of Health and Welfare, Australia’s National Drug and Alcohol Research Centre, and the United Nations Office on Drugs and Crime. In compiling this summary of key issues, preference was given to robust empirical research and data collection. Key findings are presented in two parts. The first explores the social and environmental conditions, key events, and features of synthetic opioids that led to the current epidemics in Australia. The second discusses the connection between the concepts in the literature review and the effect of opioid misuse in our society.
In 2020, there were 1,073 opioid-induced deaths among Australians, says a new study published by researchers at the National Drug and Alcohol Research Centre (NDARC), UNSW Sydney. The majority of drug-induced deaths were due to unintentional drug overdose and opioids were the most commonly identified substances involved (Chrzanowska et al., 2022).
Findings
In the data collection exercise, there were 99 entries on the drug classification opioid, including heroin, codeine, and methadone. This is not surprising, given that opioid drugs are among the most powerful analgesics but also among the most addictive (Volkow et al., 2019). However, I noticed that even though opioid is classified as a drug, pharmaceutical opioids such as oxycodone, fentanyl, and morphine are often prescribed for the management of strong pain. These types of opioids are classified as analgesic medicine and have the purpose of relieving pain and treating respiratory illness. This finding from the data led me to explore more and found that opioid misuse has become a crisis, not only in Australia but also in the USA and Canada (AIHW, 2018). In this case, opioid misuse is defined as the inappropriate or excessive use of opioids. In 2019, another research by the AIHW showed that over 8% of Australians aged 14 years and older reported having used prescription opioids for non-medical purposes. This attracted my interest to start the research question of why opioid misuse has become a crisis in Australia.
Discussion
The study indicates the issue of opioid misuse by the Australian population and its impact on people’s health and society in general. At the same time, the review of relevant literature demonstrates that opioid misuse is directly connected with healthcare-related systemic issues. According to the Australian Department of Health and Aged Care (2019), one of the contributing factors that determine the increase in opioid misuse is a lack of reliable research. Thus, opioids are used to soothe pain in the case of various types of chronic non-cancer conditions “despite limited evidence of efficacy or safety for opioids in many of those patients” (Australian Department of Health and Aged Care, 2019, par. 2). In addition, the application of opioids for chronic pain “is also driven by the inconsistent efficacy of alternative medicines,” such as antidepressants, muscle relaxants, non-steroidal anti-inflammatory drugs (NSAIDs), and gabapentin (Australian Department of Health and Aged Care, 2019, par. 2). Moreover, opioid analgesics are frequently prescribed when pain cannot be dealt by other treatments. Thus, inappropriate or excessive use of opioids in Australia leads to their misuse and associated health issues.
Another factor in the increase in Australia’s opioid misuse is a lack of professional skills and knowledge related to modern and more efficient pain medications. In particular, Australian dentists excessively prescribe opioids, such as the combination of paracetamol with codeine, regardless of the availability of safe NSAIDs (Teoh, et al., 2020). In addition, inappropriate medical skills are associated with the absence of a patient’s medical history or assigning inadequate treatment (Cragg et al., 2019; Lalic et al., 2018). Moreover, the devastating consequences of opioid misuse are directly connected with the accessibility of health care. According to the Australian Institute of Criminology, “fentanyl use is highest in less populated and more remote locations, and in areas with greater socio-economic disadvantage and a higher proportion of older people” (Brown and Morgan, 2019, p. 7). In other words, when quality health care is inaccessible, people use opioids for pain relief without knowing the appropriate dosage.
At the same time, even the availability of healthcare services cannot guarantee the absence of opioid misuse. Thus, according to Luckett et al. (2020), opioid-related misuse is connected with poor continuity of health care and poor communication between a healthcare provider and a patient that limits shared understanding and shared prescribing arrangements. In addition, a lack of patient-doctor cooperation leads to the absence of patient education. In other words, patients are not provided with essential information related to the negative consequences of opioid misuse, such as mixing opioids with other medications or alcohol. Moreover, a patient’s opinion may be ignored, especially in the case of standard overprescribing on discharge when a patient’s concerns related to this unnecessary practice are not considered. Finally, the standards of the modern healthcare system limit specialists’ involvement (Luckett et al., 2020). In other words, due to time constraints, healthcare specialists cannot provide quality and patient-centered pain management.
In general, regardless of multiple medication variants, opioids are still regarded as the most appropriate and non-stigmatized option for pain management, especially in the case of chronic pain. However, multiple problems that exist in the healthcare system, including the inaccessibility of healthcare services, a lack of specialists’ professional skills, and the absence of patient-doctor cooperation and patient education, lead to increasing opioid misuse. In this case, responsive actions should primarily presuppose the broader changes in the Australian health care system.
Conclusion
All opioid types showed stable or declining rates in 2018-2020 relative to 2017. Although overprescription of opioid medications triggered the opioid crisis, improving opioid prescription practices for pain management, although important for addressing the opioid crisis, is no longer sufficient. In parallel, strategies to expand access to medication for OUD and improve treatment retention, including the more active involvement of psychiatrists who are optimally trained to address psychiatric comorbidities, are fundamental to preventing fatalities and achieving recovery. Research into new treatments for OUD, models of care for OUD management that include health care, and interventions to prevent OUD may further help resolve the opioid crisis and prevent it from happening again.
Reference List
AIHW (Australian Institute of Health and Welfare) (2018) Opioid harm in Australia: and comparisons between Australia and Canada, AIHW, Australian Government.
Australian Institute of Health and Welfare (2020) National Drug Strategy Household Survey 2019. Canberra: AIHW.
Brown, R. and Morgan, A. (2019) ‘The opioid epidemic in North America: implications for Australia.’ Australian Institute of Criminology, 578, pp. 1-15.
Chrzanowska, A., Man, N., Sutherland, R., Degenhardt, L. & Peacock, A. (2022). Trends in overdose and other drug-induced deaths in Australia, 1997-2020. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney. DOI: 10.26190/ke9y-4731
Cragg, A. et al. (2019) ‘Risk factors for misuse of prescribed opioids: a systematic review and meta-analysis.’ Annals of Emergency Medicine, 74(5), pp. 634-646.
Lalic, S. et al. (2018) ‘Predictors of persistent prescription opioid analgesic use among people without cancer in Australia.’ British Journal of Clinical Pharmacology, 84(6), pp. 1267-1278.
Luckett, T. et al. (2020) ‘Risk of opioid misuse in people with cancer and pain and related clinical considerations: a qualitative study of the perspectives of Australian general practitioners.’ BMJ Open, 10(2), pp. 1-11. doi:10.1136/bmjopen-2019-034363
Teoh, L. et al. (2020) Dental opioid prescribing rates after the up-scheduling of codeine in Australia. Scientific Reports, 10(1), pp. 1-6.
Volkow N. D. et al. (2019) ‘Prevention and treatment of opioid misuse and addiction: A review. JAMA Psychiatry, 76(2), pp. 208–216. doi:10.1001/jamapsychiatry.2018.3126
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 person’s 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 victim’s 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.
The opioid crisis is one of the most significant public health hazards in the United States and worldwide. In 2015 alone, out of 52,404 reported drug overdose deaths, 63,1% were from opioids (Vadivelu, 2018). The wide use of non-prescription medications for chronic pain facilitates the opioid addiction rate, which challenges the governmental enforcement of complete abstinence from non-prescribed drugs. While the opioid crisis is far from going away, new strategies focus on harm reduction rather than consumption prevention. Healthcare institutions and professional nurses can adopt harm reduction and prevention strategies to reduce the risk of complications in patients with opioid use disorder and potentially reduce the consumption rate. Different strategies were applied worldwide with varying results. While some of them require further studies and experiments, others can be incorporated into existing healthcare practices to help with opioid use harm reduction.
Discussion
One of the promising directions for reducing the opioid-related death rate is introducing less dangerous alternatives like medical cannabis. Medical cannabis has been proposed and used in some states as a replacement for opioid painkillers with positive results that include reduced mortality, better pain management, and significant reduction of healthcare costs for the states and the citizens (Vyas et al., 2018). The literature review by Vyas et al. (2018) has indicated a significant substitution of medical cannabis for opioid prescriptions and, in some cases, an overall decrease in opioid use. While further research on medical cannabis is restricted mainly by federal regulations, the existing results show significant potential for reducing the opioid use rate and the degree of related harm.
Another possible way of harm reduction is drug checking which includes chemical analysis and health consultations. Measham and Turnbull (2021) point out that drug-specific and drug-related harms outside of direct drug use are major public health hazards that can be effectively addressed and mitigated by drug checking. Risk communications and subsequent improvement in risk management can lead to more efficient harm reduction practices, particularly among opioid drug users. The study by Measham and Turnbull (2021) demonstrates that brief interventions, including health consultations, facilitate a more conscious and careful approach to drug use and, in some cases, lead to a reduction in drug use. The results of this study demonstrate an approach that professional nurses can use toward patients with opioid use disorder in their practice to potentially reduce the related harm. However, the idea of reducing harm without necessarily decreasing drug consumption remains controversial among healthcare professionals (Vearrier, 2018). The question of the ethical implications of this approach requires serious consideration.
While drug use remains the primary reason for opioid-related deaths, associated risks can be addressed by healthcare facilities and nurses directly involved in working and communicating with opioid users. Opioid maintenance therapy, needle and syringe exchange programs, opioid overdose education, and naloxone distribution decrease the related harms while not necessarily reducing the consumption rate (Vearrier, 2018). Other harm reduction strategies include reforming prescribing practices and introducing alternatives to prescription opioid medicine. However, the ethical concerns of these approaches have continuously prevented the development of governmental strategies for harm reduction. Abstinence from all non-prescribed medicines has been the federal government’s focus since the advent of the opioid crisis (Taylor et al., 2021). However, introducing harm reduction approaches into primary care and nursing care settings can engage patients with ongoing substance use and facilitate the development and accessibility of screening and prevention services.
Conclusion
Despite the governmental efforts to reduce nationwide opioid consumption, the related death rate has been steadily increasing. As a result, alternative approaches to the issue have been developed. Most of them focus on preventing and reducing consumption-related health and social harms and have shown positive results in reducing mortality and use rate. However, the reluctance of the federal government to recognize the efficiency and ethical nature of harm reduction practices remains a preventing factor for the broader implementation of these strategies.
The opioid overdose crisis has been one of the significant problems for the American economy and healthcare system for more than 20 years. The documentary “Crime of the Century” by Alex Gibney reveals many details concerning the problem. The research conducted by the author of the documentary, together with his team, is the deepest and the most trustworthy one on the opioid epidemic.
Main body
The documentary reveals billion-dollar pharmaceutical companies’ shady business of prescribing drugs to ordinary people in search of enormous income. The business was started by the founder of the Purdue Pharma company and was continued by Insys. The companies’ representatives bribed doctors and officials and falsified documents to legally sell opioids, including morphine and fentanyl, to people suffering from pains of a different kind. In combination with doctors’ high credibility, such a strategy resulted in billions of dollars for the companies and millions of deaths for the country. People participating in such schemes are good psychologists and appeal to patients’ painful emotions, so people may have no idea of being deceived by professional doctors eager to relieve their pain. That is why the opioid crisis has become such a significant problem.
Corrupted doctors, on the contrary, are interested neither in their patient’s health issues nor in their lives. However, most of them are perfect actors, so they mask their desire to earn more money by concern over patients’ lives, making it impossible to be led in pain. The documentary proves that by giving examples of the same stories told either by the patient himself or his family and by the doctor prescribed opioids. Families accuse the doctor of slowly killing his patient instead of curing him. In contrast, the doctor says it is not his responsibility, as the patient took opioids prescribed to him in higher doses. The examples from the documentary confirm that companies producing opioids and doctors prescribing them are interested only in their profit.
Conclusion
To conclude, it is necessary to mention that “Crime of the Century” provides up-to-date data on one of the significant economic and health problems America faces today. Although the series seems not to suggest any possible solutions, it reveals the most crucial aspects of the problem. That is why more people should watch it to be aware of the problem and start solving it.